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CC BY-NC 4.0 · Arch Plast Surg 2015; 42(02): 194-200
DOI: 10.5999/aps.2015.42.2.194
Original Article

Early Surgical Site Infection Following Tissue Expander Breast Reconstruction with or without Acellular Dermal Matrix: National Benchmarking Using National Surgical Quality Improvement Program

Sebastian Winocour
1Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
,
Jorys Martinez-Jorge
1Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
,
Elizabeth Habermann
2Department of Health Sciences Research, Rochester, NM, USA
,
Kristine Thomsen
2Department of Health Sciences Research, Rochester, NM, USA
,
Valerie Lemaine
1Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
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Background Surgical site infections (SSIs) result in significant patient morbidity following immediate tissue expander breast reconstruction (ITEBR). This study determined a single institution's 30-day SSI rate and benchmarked it against that among national institutions participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).

Methods Women who underwent ITEBR with/without acellular dermal matrix (ADM) were identified using the ACS-NSQIP database between 2005 and 2011. Patient characteristics associated with the 30-day SSI rate were determined, and differences in rates between our institution and the national database were assessed.

Results 12,163 patients underwent ITEBR, including 263 at our institution. SSIs occurred in 416 (3.4%) patients nationwide excluding our institution, with lower rates observed at our institution (1.9%). Nationwide, SSIs were significantly more common in ITEBR patients with ADM (4.5%) compared to non-ADM patients (3.2%, P=0.005), and this trend was observed at our institution (2.1% vs. 1.6%, P=1.00). A multivariable analysis of all institutions identified age ≥50 years (odds ratio [OR], 1.4; confidence interval [CI], 1.1-1.7), body mass index ≥30 kg/m2 vs. <25 kg/m2 (OR, 3.4; CI, 2.6-4.5), and operative time >4.25 hours (OR, 1.9; CI, 1.5-2.4) as risk factors for SSIs. Our institutional SSI rate was lower than the nationwide rate (OR, 0.4; CI, 0.2-1.1), although this difference was not statistically significant (P=0.07).

Conclusions The 30-day SSI rate at our institution in patients who underwent ITEBR was lower than the nation. SSIs occurred more frequently in procedures involving ADM both nationally and at our institution.

Keywords

Breast implantation - Acellular dermis - Benchmarking - Surgical wound infection

This paper was presented at the Plastic Surgery Research Council on March 7-9, 2014 in New York, NY, USA.




Publication History

Received: 16 August 2014

Accepted: 18 November 2014

Article published online:
05 May 2022

© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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