|
|
|
|
|
|
|
|
abstract
Background
Noninfectious
wound complications (NIWCs) after 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 to 64 years with procedure codes for mastectomy from
January 2004 through December 2011. Noninfectious wound complications
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
There
were 18,696 procedures (10,836 [58%] with IR) among 18,085 women
identified. The overall NIWC rate was 9.2% (1,714 of 18,696); 56%
required surgical treatment. The NIWC rates were 5.8% (455 of 7,860)
after mastectomy only, 10.3% (843 of 8,217) after mastectomy plus
implant, 17.4% (337 of 1,942) after mastectomy plus flap, and 11.7% (79
of 677) after mastectomy plus flap and implant (p < 0.001). 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 plus flap. The percentage of NIWCs resulting
in surgical wound care varied from 50% (210 of 416) for mastectomy plus
flap, to 60% (507 of 843) for mastectomy plus implant. Early implant
removal within 60 days occurred after 6.2% of mastectomy plus implant;
66% of the early implant removals were due to NIWCs and/or surgical site
infection.
Conclusions
The
rate of NIWC was approximately 2-fold higher after mastectomy with IR
than after mastectomy only. Noninfectious wound complications were
associated with additional surgical treatment, particularly in women
with implant reconstruction, and with early implant loss.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.