title: Dressing Wear Time after Breast Reconstruction: A Randomized Clinical Trial.
abstract: BACKGROUND
  The evidence to support dressing standards for breast surgery wounds is empiric and scarce.
  
  
  OBJECTIVE
  This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions.
  
  
  METHODS
  A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100). SSIs were defined and classified according to criteria from the Centers for Disease Control and Prevention. Samples collected before placing the dressing and after 1 day (group I) and 6 days (both groups) were cultured for skin colonization assessments. Patients preferences and perceptions with regard to safety, comfort and convenience were recorded and analyzed.
  
  
  RESULTS
  A total of 186 patients completed the follow-up. The global SSI rate was 4.5%. Six patients in group I and three in group II had SSI (p = 0.497). Before dressing, the groups were similar with regard to skin colonization. At the sixth day, there was a higher colonization by coagulase-negative staphylococci in group I (p<0.0001). Patients preferred to keep dressing for six days (p<0.0001), and considered this a safer choice (p<0.05).
  
  
  CONCLUSIONS
  Despite group I had a higher skin colonization by coagulase-negative staphylococci on the sixth postoperative day, there was no difference in SSI rates. Patients preferred keeping dressing for six days and considered it a safer choice.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01148823.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.|Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Daniela Francescato
authors.initials: DF
authors.lastname: Veiga
authors.affiliation: Department of Microbiology, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Carlos Américo Veiga
authors.initials: CA
authors.lastname: Damasceno
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Joel
authors.initials: J
authors.lastname: Veiga-Filho
authors.affiliation: Department of Microbiology, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Luiz Francisley
authors.initials: LF
authors.lastname: Paiva
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Fernando Elias Martins
authors.initials: FE
authors.lastname: Fonseca
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Isaías Vieira
authors.initials: IV
authors.lastname: Cabral
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.
authors.forename: Natália Lana Larcher
authors.initials: NL
authors.lastname: Pinto
authors.affiliation: Department of Bioestatistics, Universidade do Vale do Sapucaí, Pouso Alegre, Minas Gerais, Brazil.|Department of Bioestatistics, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Yara
authors.initials: Y
authors.lastname: Juliano
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D001458:Bandages; D001943:Breast Neoplasms / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D000072836:Surgical Wound / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D013997:Time Factors