A prospective analysis of nosocomial wound infection after mastectomy
J. D. Beatty, G. V. Robinson, J. A. Zaia, J. R. Benfield, M. M. Kemeny, M. M. Meguid, D. U. Riihimaki, J. J. Terz and M. E. Lemmelin
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.
