Guidelines for Complications of Cancer Treatment Vol VIII Part B

6. Complications after breast reconstruction and implantsurgery7. Treatment related local symptoms (radiation,chemotherapy)8. Quality of life and early psychosocial implicationsGeneral surgical-wound related complicationsMost of the minor wound complications after breast surgeryare not well documented and managed as outpatients and occurin up to 30% cases. These are mainly minor wound infections,seroma and hematoma managed conservatively.Wound infection rates postoperatively after breast surgery havebeen reported in various retrospective studies ranging from 3-15% [1-4] and some Phase III studies of preoperativeantibiotics with varied effects on wound infection rates.[5-7]The largest data on wound infection is a meta-analysis reportedby Platt et al in 1993 [8]. The wound infection rates wereanalyzed in 2587 breast surgeries with a 3.8% infection rate,most commonly by staphylococcal skin flora. Most commonrisk factors in all these studies have been old age, obesity, anddiabetes, tobacco smoking and alcohol consumption. Prioropen biopsy has also been implicated as a cause of higherwound infection after definitive surgery as compared to needlebiopsy [9,10]. Smoking and diabetes are known to affect thesmall vessels in the skin and lead to delays in wound healingand wound dehiscence, and increase wound infection ratesnearly four-fold [2].Role of preoperative antibioticsPreoperative and perioperative antibiotics have been variouslyused to reduce wound infections in surgical procedures. Butmost of these are biased towards use in only high risk cases orinfected cases. As routine use in elective clean cases, antibiotic4