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J. David Beatty, MD; Gayle V. Robinson, RN; John A. Zaia, MD; John R. Benfield, MD; M. Margaret Kemeny, MD; Michael M. Meguid, MD, PhD; Daniel U. Riihimaki, MD; Jose J. Terz, MD; Mary E. Lemmelin, RN

Arch Surg. 1983;118(12):1421-1424.

Abstract
• We evaluated the postoperative course of all patients who had mastectomies from 1978 through 1982 at City of Hope National Medical Center (Duarte, Calif). The overall clean mastectomy wound infection rate was 24/294 (8.2%). The incidence of mastectomy wound infection varied with the method of biopsy and was 3.2% after needle aspiration and 9.5% after open biopsy. Mastectomy immediately after open biopsy ("one step") had an infection rate of 5.3%, whereas mastectomy at a subsequent procedure ("two step") had a rate of 12.4%. The maximal infection rate (23.0%) occurred following the two-step procedure when the interval was four to seven days. The infection rates for patients hospitalized three or more days before mastectomy were elevated, but no significant correlation was observed between the infection rate and other demographic factors. We recommend that needle aspiration biopsy be used prior to open biopsy to minimize the need for a two-step approach to mastectomy.

(Arch Surg 1983;118:1421-1424)

Author Affiliations
From the Division of Surgery (Drs Beatty, Benfield, Kemeny, Meguid, Riihimaki, and Terz), the Infection Control Office (Mss Robinson and Lemmelin), and the Department of Infectious Diseases (Dr Zaia), City of Hope National Medical Center, Duarte, Calif.

Footnotes
Accepted for publication July 26, 1983.

Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Rancho Mirage, Calif, Jan 16, 1983.

Reprint requests to Department of General Oncologic Surgery, City of Hope National Medical Center, 1500 E Duarte Rd, Duarte, CA 91010 (Dr Beatty).

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