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Surgical Site Infection (SSI) Rates Among Patients Who Underwent Mastectomy After the Introduction of SSI Prevention Policies

Published online by Cambridge University Press:  21 June 2016

Diana Vilar-Compte ,
Rodrigo Roldán-Marín ,
Carlos Robles-Vidal  and
Patricia Volkow
Diana Vilar-Compte*
Affiliation:
Department of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico
Rodrigo Roldán-Marín
Affiliation:
Department of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico Dermatology Department, Hospital General “Dr. Manuel Gea Gonzalez, ” Mexico City, Mexico
Carlos Robles-Vidal
Affiliation:
Breast Tumor Department, Instituto Nacional de Cancerología, Mexico City, Mexico
Patricia Volkow
Affiliation:
Department of Infectious Diseases, Instituto Nacional de Cancerología, Mexico City, Mexico
*
Departamento de Infectologia, Instituto Nacional de Cancerologia (INCan), Av. San Fernando 22, Col. Seccion XVI, Mexico City, 14080, Mexico, ([email protected])
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Abstract

Objective.

To describe the results of an intervention program to reduce the rate of surgical site infection (SSI) in the breast tumor department of a referral teaching hospital for patients with cancer.

Methods.

Preventive measures introduced in the Breast Tumor Department of the study hospital included the following: starting in July 2000, use of sterile technique for wound care; starting in 2001, use of closed antireflux silicone evacuation systems, use of perioperative antimicrobial prophylaxis, provision of feedback to surgeons, and remodeling of the ambulatory wound care clinic. We conducted surveillance of all patients who underwent mastectomy between February 1 and December 31, 2001, and the SSI rate was calculated. A case-control analysis was performed for risk factors known to be associated with SSI. Results were compared with the data from 2000.

Results.

The study included data on 385 surgeries. SSIs were registered in 52 (13.7%) of these 385, which was a rate 58.6% less than the 2000 infection rate (33.1%). Risk factors associated with SSI included concomitant chemotherapy and radiation therapy (OR, 3.6 [95% confidence interval {CI}, 1.9-7.1]), surgery performed during an evening shift (OR, 1.9 [95% CI, 1.1-3.6]), and insertion of a second drainage tube during the late postoperative period (OR, 2.8 [95% CI, 1.4-5.7]). The mean number (± SD) of postoperative visits to the outpatient wound care clinic was reduced from 11.6 ± 7.1 in 2000 to 9.2 ± 4.4 in 2001 (P< .001, Student's t test). The mean number of days that the evacuation systems were used was reduced from 19.0 to 16.0 days (P =.001, Student's t test).

Conclusions.

Continuous wound surveillance, along with feedback to surgeons, use of closed antireflux evacuation systems, and standardized practices in wound and drainage-tube care, decreased by 58.6% the rate of SSI in a breast surgical department with high rates of infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 8 , August 2006 , pp. 829 - 834
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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