Impact of Specimen Weight and Body Mass Index on Surgical Site Infection following Mastectomy in a South Indian Tertiary Care Center

Background: A major post-operative complication that is associated with significant morbidity and increased health care costs is surgical site infection (SSI). Though Mastectomy is classified as a clean surgical procedure, done under strict asepsis, SSI still continues to occur and may delay recovery and start of adjuvant therapy. This study aims to determine the incidence of SSI following mastectomy and to identify associated risk factors. Materials and Methods: This prospective observational study was done in a tertiary care teaching hospital in Tamilnadu and included 149 females, who were above 18 years and underwent simple, modified radical, or radical mastectomy. The study was done over a period of two years. Immunocompromised patients or patients under prior chemotherapy were excluded. 30 day post operative follow up was done for all patients and SSI was diagnosed based on criteria devised by Centers for Disease Control and Prevention (CDC). Results: SSI was noted in 46 patients, with an incidence of 30.9%. Culture was positive in 22 cases (47.8%), while 24 cases (52.2%) were culture-negative. Staphylococcus aureus was the most common organism isolated. Higher BMI and greater specimen weight showed significant association with SSI. Other factors such as age, diabetes mellitus, serum albumin, type of mastectomy, and hospital stay did not show significant correlation. Conclusion: Higher BMI and increased specimen weight are significant predictors of SSI following mastectomy. Identification of high-risk patients may help in improving perioperative care and reducing postoperative infections.