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Surgical Site Infection after Breast Surgery: Impact of 2010 CDC Reporting Guidelines

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Reported surgical site infection (SSI) rates after breast operations ranges 0.8–26 % in the literature. The aims of the present study were to characterize SSI after breast/axillary operations and determine the impact on the SSI rate of the 2010 Centers for disease control and Prevention (CDC) reporting guidelines that now specifically exclude cellulitis.

Methods

Retrospective chart review identified 368 patients with 449 operated sides between July 2004 and June 2006. SSI was defined by CDC criteria: purulent drainage (category 1), positive aseptically collected culture (category 2), signs of inflammation with opening of incision and absence of negative culture (category 3), and physician diagnosis of infection (category 4). The impact of excluding cellulitis was assessed.

Results

Prior CDC reporting guidelines revealed that among 368 patients, 32 (8.7 %) experienced SSI in 33 (7.3 %) of 449 operated sides. Of these, 11 (33 %) met CDC criteria 1–3, while 22 (67 %) met CDC criterion 4. Excluding cellulitis cases per 2010 CDC SSI reporting guidelines eliminates 21 of the 22 infections previously meeting CDC criterion 4. Under the new reporting guidelines, the SSI rate is 12 (2.7 %) of 449 operated sides. SSI rates varied by procedure, but these differences were not statistically significant.

Conclusions

Cellulitis after breast and axillary surgery is much more common than other criteria for SSI, and SSI rates are reduced almost threefold if cellulitis cases are excluded. Recently revised CDC reporting guidelines may result in underestimates of the clinical burden of SSI after breast/axillary surgery.

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Acknowledgment

A.C.D. is supported by the CA90628-08 Paul Calabresi Award for Clinical–Translational Research (K12) via the Mayo Clinic Cancer Center. This project was also supported by NIH/NCRR CTSA grant UL1 RR024150. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Sincere appreciation to Marilyn Churchward for assistance with manuscript preparation.

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Author notes

  1. Alyssa D. Throckmorton MD

    Present address: University of Tennessee Health Science Center, Memphis, TN, USA

Authors and Affiliations

  1. Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Amy C. Degnim MD, FACS, Alyssa D. Throckmorton MD, Sarah Y. Boostrom MD, Judy C. Boughey MD, FACS & Andrea Holifield CNP

  2. Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, MN, USA

    Larry M. Baddour MD

  3. Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA

    Tanya L. Hoskin MS

Authors
  1. Amy C. Degnim MD, FACS
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  2. Alyssa D. Throckmorton MD
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  3. Sarah Y. Boostrom MD
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  4. Judy C. Boughey MD, FACS
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  5. Andrea Holifield CNP
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  6. Larry M. Baddour MD
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  7. Tanya L. Hoskin MS
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Corresponding author

Correspondence to Amy C. Degnim MD, FACS.

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Degnim, A.C., Throckmorton, A.D., Boostrom, S.Y. et al. Surgical Site Infection after Breast Surgery: Impact of 2010 CDC Reporting Guidelines. Ann Surg Oncol 19, 4099–4103 (2012). https://doi.org/10.1245/s10434-012-2448-6

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  • DOI: https://doi.org/10.1245/s10434-012-2448-6

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