Reducing Surgical Site Infection in Implant Based Breast Reconstruction: A Multidisciplinary Quality Improvement Project.
Joseph Banuelos, BA1, Si-Gyun Roh, MD1, Tina J. Hieken, MD1, Valerie Lemaine, MD, MPH1, James W. Jakub, MD1, Michel Saint-Cyr, MD2, Elie F. Berbari, MD1, Basel Sharaf, MD1.
1Mayo Clinic, Rochester, MN, USA, 2Baylor College of Medicine, Houston, TX, USA.
PURPOSE: to report the effects of implementing best practice recommendations at our institution to reduce surgical site infection (SSI) rates in implant based breast reconstruction.
METHODS: After approval by the Institutional Review Board, a retrospective 5 year electronic chart review was performed to examine SSI rates at our institution. Women who underwent mastectomy and prosthetic breast reconstruction were included. We utilized the Centers for Disease Control and Prevention definitions of SSI. The bundled intervention protocol is summarized in figure 1. Patient's demographics and comorbidities were examined, and infection rates were calculated prior to and after the interventions.
RESULTS: A total of 1004 women were included in the study. Age and medical comorbidities were similar between the two groups. In the pre-intervention group, 51 patients developed SSI from a total of 497, with an infection rate of 11.9%. In the post-intervention group, 36 patients out of 507 developed SSI with a rate of 7.1% (p= 0.001), figure 2.
CONCLUSION: The implementation of best-practice bundled interventions at our institution has been an effective quality improvement project addressing SSI in implant based breast reconstruction. Emphasis is currently placed on maintenance of these interventions. A multidisciplinary approach that involves patients, surgeons, infectious disease specialists and allied health care personnel was essential to this quality improvement effort.
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