Occurence and risk factors for wound infections in breast cancer surgery

BACKGROUND: In order to evaluate occurrence and risk factors for wound infe ction (WI) in breast cancer surgery, we carried out a prospective study. METHODS: From September 1996 through April 1997, an infection control physi cian prospectively evaluated 542 wounds of all patients having breast cance r surgery at the Oscar Lambret Cancer Center. WI was defined as a wound wit h pus. Antibiotic prophylaxis was given in case of immediate breast reconst ruction. Statistical evaluation was performed using the c less than or equa l to test for categorial data and non-parametric Mann-Whitney test for cont inuous data. In univariate analysis, differences were considered significan t at p<0.01. RESULTS: The overall WI rate was 3.51% (19/352). In univariate analysis, ri sk factors for WI were: total preoperative hospital stay (p=0.01), previous chemotherapy (p=0.01), previous oncologic surgery (p=0.03) and imme- diate breast reconstruction (p=0.002). In multivariate analysis, we observed two independant predictive factors for WI :previous chemotherapy (p=0.05) and immediate breast reconstruction (0=0.02). CONCLUSIONS: Previous anticancer chemotherapy was a major risk factor In th ese cases, a phase III trial could confirm efficacy of standard antibiotic prophylaxis. Breast reconstruction was the second major risk factor Standar d antibiotic prophylaxis (used in our study) was insufficient.