Surgical site infection following breast cancer surgery: a single centre study
Association of Breast Surgery ePoster Library. Caisley L. 05/15/17; 166304; P042
Louise Caisley
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Abstract
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Introduction There are few reports in the literature about surgical site infection (SSI) following breast cancer surgery. The National Mastectomy and Breast Reconstruction Audit reported infection rates of 17% following mastectomy and just over 24% for patients receiving mastectomy with immediate implant reconstruction. We conducted a prospective study of SSI in 383 breast cancer surgery patients during a nine-month period between October 2014 and June 2015.
Method In 2014 our hospital agreed to participate in Public Health England's Surgical Site Infection Surveillance. An independent observer using OPCS codes identified all patients having breast cancer surgery for inclusion into the study. Each patient completed a 30-day post-discharge questionnaire either by telephone interview or face to face if readmitted. Patients who were identified with a potential SSI had further investigation to ascertain if they met the PHE criteria for SSI.
Results 383 patients were contacted during the study period: 269 (70.2%) patients had breast conserving surgery (BCS); 67 (17.4%) a mastectomy with or without axillary surgery; and 47 (12.2%) patients had mastectomy with immediate implant reconstruction.
Out of 383 breast cancer surgery patients: 40 patients were further investigated for a SSI; and 5 patients had a confirmed SSI (1.3%). The 5 patients with confirmed SSI comprised: 2 patients who had BCS (0.7%); one patient who had mastectomy with or without axillary surgery (1.4%); and 2 patients who had mastectomy with immediate reconstruction (4.2%). Further analysis of the data revealed that: of the 269 BCS patients 29 (10.7%) received perioperative antibiotics and 4 post discharge antibiotics; of the 67 mastectomy with or without axillary surgery patients 19 (28.3%) received perioperative antibiotics and 5 post discharge antibiotics; of the 47 patients receiving mastectomy with immediate reconstruction 46 (97%) received perioperative antibiotic and 23 post discharge antibiotics.
Conclusion. Our low rates of infection in patients receiving breast conserving surgery or mastectomy suggests that our prophylactic antibiotic policy does not require immediate review but careful audit of outcomes should continue, particularly, in the patients undergoing mastectomy with immediate implant based reconstruction.
Method In 2014 our hospital agreed to participate in Public Health England's Surgical Site Infection Surveillance. An independent observer using OPCS codes identified all patients having breast cancer surgery for inclusion into the study. Each patient completed a 30-day post-discharge questionnaire either by telephone interview or face to face if readmitted. Patients who were identified with a potential SSI had further investigation to ascertain if they met the PHE criteria for SSI.
Results 383 patients were contacted during the study period: 269 (70.2%) patients had breast conserving surgery (BCS); 67 (17.4%) a mastectomy with or without axillary surgery; and 47 (12.2%) patients had mastectomy with immediate implant reconstruction.
Out of 383 breast cancer surgery patients: 40 patients were further investigated for a SSI; and 5 patients had a confirmed SSI (1.3%). The 5 patients with confirmed SSI comprised: 2 patients who had BCS (0.7%); one patient who had mastectomy with or without axillary surgery (1.4%); and 2 patients who had mastectomy with immediate reconstruction (4.2%). Further analysis of the data revealed that: of the 269 BCS patients 29 (10.7%) received perioperative antibiotics and 4 post discharge antibiotics; of the 67 mastectomy with or without axillary surgery patients 19 (28.3%) received perioperative antibiotics and 5 post discharge antibiotics; of the 47 patients receiving mastectomy with immediate reconstruction 46 (97%) received perioperative antibiotic and 23 post discharge antibiotics.
Conclusion. Our low rates of infection in patients receiving breast conserving surgery or mastectomy suggests that our prophylactic antibiotic policy does not require immediate review but careful audit of outcomes should continue, particularly, in the patients undergoing mastectomy with immediate implant based reconstruction.
Introduction There are few reports in the literature about surgical site infection (SSI) following breast cancer surgery. The National Mastectomy and Breast Reconstruction Audit reported infection rates of 17% following mastectomy and just over 24% for patients receiving mastectomy with immediate implant reconstruction. We conducted a prospective study of SSI in 383 breast cancer surgery patients during a nine-month period between October 2014 and June 2015.
Method In 2014 our hospital agreed to participate in Public Health England's Surgical Site Infection Surveillance. An independent observer using OPCS codes identified all patients having breast cancer surgery for inclusion into the study. Each patient completed a 30-day post-discharge questionnaire either by telephone interview or face to face if readmitted. Patients who were identified with a potential SSI had further investigation to ascertain if they met the PHE criteria for SSI.
Results 383 patients were contacted during the study period: 269 (70.2%) patients had breast conserving surgery (BCS); 67 (17.4%) a mastectomy with or without axillary surgery; and 47 (12.2%) patients had mastectomy with immediate implant reconstruction.
Out of 383 breast cancer surgery patients: 40 patients were further investigated for a SSI; and 5 patients had a confirmed SSI (1.3%). The 5 patients with confirmed SSI comprised: 2 patients who had BCS (0.7%); one patient who had mastectomy with or without axillary surgery (1.4%); and 2 patients who had mastectomy with immediate reconstruction (4.2%). Further analysis of the data revealed that: of the 269 BCS patients 29 (10.7%) received perioperative antibiotics and 4 post discharge antibiotics; of the 67 mastectomy with or without axillary surgery patients 19 (28.3%) received perioperative antibiotics and 5 post discharge antibiotics; of the 47 patients receiving mastectomy with immediate reconstruction 46 (97%) received perioperative antibiotic and 23 post discharge antibiotics.
Conclusion. Our low rates of infection in patients receiving breast conserving surgery or mastectomy suggests that our prophylactic antibiotic policy does not require immediate review but careful audit of outcomes should continue, particularly, in the patients undergoing mastectomy with immediate implant based reconstruction.
Method In 2014 our hospital agreed to participate in Public Health England's Surgical Site Infection Surveillance. An independent observer using OPCS codes identified all patients having breast cancer surgery for inclusion into the study. Each patient completed a 30-day post-discharge questionnaire either by telephone interview or face to face if readmitted. Patients who were identified with a potential SSI had further investigation to ascertain if they met the PHE criteria for SSI.
Results 383 patients were contacted during the study period: 269 (70.2%) patients had breast conserving surgery (BCS); 67 (17.4%) a mastectomy with or without axillary surgery; and 47 (12.2%) patients had mastectomy with immediate implant reconstruction.
Out of 383 breast cancer surgery patients: 40 patients were further investigated for a SSI; and 5 patients had a confirmed SSI (1.3%). The 5 patients with confirmed SSI comprised: 2 patients who had BCS (0.7%); one patient who had mastectomy with or without axillary surgery (1.4%); and 2 patients who had mastectomy with immediate reconstruction (4.2%). Further analysis of the data revealed that: of the 269 BCS patients 29 (10.7%) received perioperative antibiotics and 4 post discharge antibiotics; of the 67 mastectomy with or without axillary surgery patients 19 (28.3%) received perioperative antibiotics and 5 post discharge antibiotics; of the 47 patients receiving mastectomy with immediate reconstruction 46 (97%) received perioperative antibiotic and 23 post discharge antibiotics.
Conclusion. Our low rates of infection in patients receiving breast conserving surgery or mastectomy suggests that our prophylactic antibiotic policy does not require immediate review but careful audit of outcomes should continue, particularly, in the patients undergoing mastectomy with immediate implant based reconstruction.
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