Surgical Site Infection Complicating Breast Cancer Surgery in Kuwait

Abstract

Background and Objectives. Surgical site infection (SSI) is the most common postoperative complication associated with breast cancer surgery. The present investigation aimed to determine the SSI rate after breast cancer surgeries and the causative microorganisms. Patients and Methods. All patients who underwent breast surgery in Kuwait Cancer Control Center as a treatment for breast cancer from January 2009–December 2010 were prospectively followed for the development of SSI. Indirect detection was used to identify SSIs through medical record to review and discussion with the treating surgeons. Results. The number of operations was 438. Females represented 434 (99.1%) cases while males constituted only 4 (0.9%) cases. SSIs were diagnosed after 10 operations, all for female cases. Most of the SSIs (8 cases; 80%) were detected after patients were discharged, during outpatient followup. Out of those 5/8; (62.5%) were readmitted for management of SSI. Nine patients (90%) received systemic antibiotic therapy for management of their wound infection. The SSI rate was 2.3%. The main causative organism was Staphylococcus aureus (S. aureus) which was responsible for 40% of infections. Gram negative bacteria were isolated from 40% of the cases. Conclusion. SSI is an important complication following breast cancer surgery. Microbiological diagnosis is an essential tool for proper management of such patients.

Experience with modified radical mastectomy in a low-income country: a multi-center prospective observational study

“…The rate of seroma for mastectomy patients in other studies has been reported to range between 3 and 85% with an average of 39%, which is higher than the result we have found in our study, which was 17.2% [22,23]. On the contrary, the rate of surgical site infections, 14.9% in our study, was higher in our patient population compared to published reports which ranged between 2 and 6% [24][25][26]. Reports indicated older age, Hypertension, high volume of drainage output, serum protein concentration, longer operative time, and lack of patient-controlled analgesia to be risk factors for seroma formation [23,[27][28][29].…”

The relationship between post-surgery infection and breast cancer recurrence

“…Moreover, the retrospective nature of the majority of the studies may have influenced the SSI rate recorded, possibly resulting in higher rates due to follow-up being conducted on an outpatient basis. If an SSI developed but did not require readmission then it may not have been documented in the patient records, meaning it was not included in the study [16,76]. Almost one-third of the studies had a follow-up period of one month, owing to the fact that an SSI is typically defined as occurring within the 30-day time period after surgery [168].…”

Outpatient surgical care in sub‐Saharan Africa: Learning points for low‐ and high‐income settings

“…In addition to local wound care, empiric treatment with systemic antibiotics to cover Pseudomonas species should be considered for those women who later present with postoperative wound infection. Although colonization of chronic and malignant wounds with Pseudomonas species has been well described, the association between postoperative Pseudomonas species wound infections and pre‐existing malignant breast wounds is less known . The study reminds us that we can all learn from one another and that funding for research in distant settings may generate findings applicable to local situations.…”

“…14 The authors reported that women who presented with fungating tumors were more likely to have postoperative wound infections than women who did not and that with Pseudomonas species has been well described, the association between postoperative Pseudomonas species wound infections and preexisting malignant breast wounds is less known. [15][16][17] The study reminds us that we can all learn from one another and that funding for research in distant settings may generate findings applicable to local situations.…”