Plastic Surgery Research Council
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Presenter: Daniela F Veiga, MD, PhD
Co-Authors: Veiga-Filho J; Mendes DA; Sales EM; Damasceno CA; Ferreira LM
Federal University of Sao Paulo and Universidade do Vale do Sapucai

Background: One of the major risk variables for surgical site infection is wound management in the postoperative period. Understanding infection risk factors for breast operations is essential to develop infection-prevention strategies and improve surgical outcomes. However, the evidence to support dressing standards for breast surgery wounds is empiric and scarce. This randomized controlled trial aimed to assess the influence of dressing wear time on surgical site infection rates and skin colonization.

Methods: The calculated sample size for this trial is 200 patients. Here we present preliminary results from 100 patients. Patients undergoing immediate or delayed breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on postoperative day 1, n=50) or group II (dressing removed on postoperative day 6, n=50). Surgical site infections were defined by standard criteria from the Centers for Disease Control and Prevention. Skin colonization was assessed by culture of samples collected at predefined time points.

Results: There were no differences between groups with regard to age and body mass index, but duration of operation was longer in group I (p = 0.002). Patients in group I also underwent more immediate reconstruction (p = 0.016). Six (6%) patients had infection, four from group I and two from group II (p = 0.678). There was no difference between the groups in regard to skin colonization prior dressing, but, on postoperative day 6, there was a higher skin colonization by coagulase-negative staphylococci in group I (p = 0.003).

Conclusions: These preliminary results demonstrated no difference in surgical site infection rates between groups, but we observed higher colonization levels in group I on postoperative day 6.

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