Background: This randomized controlled trial was designed to assess whether dressing wear time could influence surgical-site infection rates and skin colonization. Patients' perception at self-assessment was also analyzed.
Methods: Seventy patients undergoing reduction mammaplasty were randomly allocated to group I (dressing removed on postoperative day 1) or group II (dressing removed on postoperative day 6). Surgical-site infections were defined by standard criteria from the Centers for Disease Control and Prevention. Skin colonization was assessed by a culture of samples collected at predefined time points. Patients scored dressing wear time in regard to safety, comfort, and convenience.
Results: Nine patients (12.9 percent) had an infection, seven from group I and two from group II (p = 0.09). There was no difference between the groups in regard to skin colonization before dressing, but on postoperative day 6, there was higher skin colonization by coagulase-negative staphylococci in group I (p = 0.000). If they had the choice, 66 percent of the patients in group I would choose to keep the dressing for 1 day, whereas 83 percent of the patients in group II would prefer to keep the dressing for 6 days (p = 0.000). Patients in group II also considered keeping the dressing for 6 days a safer choice (p < 0.05).
Conclusions: There was no difference in surgical-site infection rates between groups, but higher colonization levels were observed in group I on postoperative day 6. Most of the patients would choose to keep dressing for 6 days postoperatively, which was perceived as a safer choice.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
São Paulo and Pouso Alegre, Brazil
From the Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, and the Division of Plastic Surgery, Department of Surgery, Department of Microbiology, School of Medicine, and Department of Biostatistics, Universidade do Vale do Sapucaí.
Received for publication April 24, 2011; accepted July 21, 2011.
This trial is registered under the name “Dressing Wear Time after Reduction Mammaplasty,” ClinicalTrials.gov identification number NCT01002391 (http://clinicaltrials.gov/ct2/show/NCT01002391).
Disclosures: The authors have no financial interest to declare in relation to the content of this article. No outside funding was received.
Daniela Francescato Veiga, M.D., Ph.D.; Division of Plastic Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros, 715 – 4° andar, CEP 04024-002 São Paulo, S.P., Brazil, email@example.com