Skin and soft tissue infections after breast surgery

Curr Opin Infect Dis. 2019 Apr;32(2):87-94. doi: 10.1097/QCO.0000000000000531.

Abstract

Purpose of review: Breast surgery is considered a clean surgical procedure; nevertheless, infection rates are often higher than those reported after other similarly considered clean surgeries (e.g., thyroid, hernia). Acute bacterial skin and soft tissue infections, mostly surgical site infections and implant-associated infections are commonest events that could complicate postoperative care.

Recent findings: Risk of infection is closely related to surgery procedure itself and patients host factors. Gram-positive bacteria with pattern of antimicrobial resistance are increasingly isolated and before today less frequent causes such as gram negative and mycobacteria infections. Impact of postoperative complications is underestimated and lacking an appropriate care and education for local and systemic management.

Summary: We report the current evidence on the management of infections after breast surgery. New drugs options for methicillin-resistant Staphylococcus aureus and other gram positive should have a place in this setting. Stewardship activities aiming at reducing infections risks with the correct considerations of host, microbiological and surgical risk factors.

Publication types

  • Review

MeSH terms

  • Breast / surgery*
  • Disease Management*
  • Female
  • Gram-Negative Bacteria / classification
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / classification
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Mycobacterium / classification
  • Mycobacterium / isolation & purification
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / epidemiology*
  • Soft Tissue Infections / diagnosis
  • Soft Tissue Infections / drug therapy
  • Soft Tissue Infections / epidemiology*
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / methods
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / epidemiology*