Details:

Alternative Title:
J Am Coll Surg
Publisher's site:
http://dx.doi.org/10.1016/j.jamcollsurg.2016.01.050
Personal Author:
Nickel, Katelin B ; Fox, Ida K ; Margenthaler, Julie A ; Wallace, Anna E ; Fraser, Victoria J ; ... More +
Nickel, Katelin B ; Fox, Ida K ; Margenthaler, Julie A ; Wallace, Anna E ; Fraser, Victoria J ; Olsen, Margaret A Less -
Description:
Background

Non-infectious wound complications (NIWCs) following mastectomy are not routinely tracked and data are generally limited to single-center studies. Our objective was to determine the rates of NIWCs among women undergoing mastectomy and assess the impact of immediate reconstruction (IR).

Study Design

We established a retrospective cohort using commercial claims data of women aged 18–64 years with procedure codes for mastectomy from 1/2004–12/2011. NIWCs within 180 days after operation were identified by ICD-9-CM diagnosis codes and rates were compared among mastectomy with and without autologous flap and/or implant IR.

Results

18,696 procedures (10,836 [58%] with IR) among 18,085 women were identified. The overall NIWC rate was 9.2% (1,714/18,696); 56% required surgical treatment. The NIWC rates were 5.8% (455/7,860) after mastectomy-only, 10.3% (843/8,217) after mastectomy + implant, 17.4% (337/1,942) after mastectomy + flap, and 11.7% (79/677) after mastectomy + flap and implant (p<0.001). The rates of individual NIWCs varied by specific complication and procedure type, ranging from 0.5% for fat necrosis after mastectomy-only to 7.2% for dehiscence after mastectomy + flap. The percentage of NIWCs resulting in surgical wound care varied from 50% (210/416) for mastectomy + flap to 60% (507/843) for mastectomy + implant. Early implant removal within 60 days occurred after 6.2% of mastectomy + implant; 66% of the early implant removals were due to NIWCs and/or surgical site infection.

Conclusions

The rate of NIWC was approximately two-fold higher after mastectomy with IR than after mastectomy-only. NIWCs were associated with additional surgical treatment, particularly in women with implant reconstruction, and with early implant loss.


Subject:
[+]
Breast Implantation
Breast Implants
Breast Neoplasms
Fat Necrosis
Female
Hematoma
Humans
Mastectomy
Middle Aged
Necrosis
Prosthesis Failure
Retrospective Studies
Surgical Flaps
Surgical Wound Dehiscence

Source:
J Am Coll Surg. 222(5):844-852.e1.
Pubmed ID:
27010582
Pubmed Central ID:
PMC4846523
Document Type:
Journal Article
Funding:
R01 CA149614/CA/NCI NIH HHS/United States ; R24 HS019455/HS/AHRQ HHS/United States ; U54 CK000162/CK/NCEZID CDC HHS/United States ; UL1 TR000448/TR/NCATS NIH HHS/United States
R01 CA149614/CA/NCI NIH HHS/United States ; R24 HS019455/HS/AHRQ HHS/United States ; U54 CK000162/CK/NCEZID CDC HHS/United States ; UL1 TR000448/TR/NCATS NIH HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:bd11df93d818f95d0ccb63936e5e28ccd6fa722e7c8aa6b19611db8dcf6db097
File Type:

Supporting Files

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