Background: Explore the risk factors, etiology, and drug resistance of infection after plastic surgery, and present corresponding measures.
Methods: We retrospectively analyzed 980 patients who underwent head and facial plastic surgery from January 2013 to December 2015. Postoperative infection occurred in 169 patients. We analyzed the distribution of pathogenic bacteria in patients undergoing plastic surgery, reviewed the drug resistance of Gram negative (G-) bacteria and Gram positive (G+) bacteria, and analyzed the effects of surgical duration, prophylactic use of antibacterial agents, length of stay (LOS), and preoperative hair removal on infection after plastic surgery.
Results: G+ bacteria (mainly Staphylococcus aureus) accounted for 45.6%, while G- bacteria (mainly Pseudomonas aeruginosa and Klebsiella pneumoniae) accounted for 54.4% of total pathogenic bacteria in patients undergoing plastic surgery. The most commonly resistant antibacterial agents of Pseudomonas aeruginosa were sulfamethoxazole, ciprofloxacin, and cefotaxime; the most commonly resistant antibacterial agents of Klebsiella pneumoniae were sulfamethoxazole and gentamicin. The most commonly resistant antibacterial agents of Staphylococcus aureus were penicillin G, ampicillin, and sulfamethoxazole; for coagulase-negative staphylococcus, the most commonly resistant antibacterial agents were also penicillin G, ampicillin, and sulfamethoxazole. Both Staphylococcus aureus and coagulase-negative staphylococcus were sensitive to vancomycin and teicoplanin. Multi-factor logistic regression analysis showed that surgical duration >3 hours, no prophylactic use of antibacterial agents, and LOS>7 days were independent risk factors for postoperative infection.
Conclusions: G- bacteria were more prevalent in infections after plastic surgery, and most bacteria were sensitive to imipenem and meropenem. Strict control of surgical duration, short LOS, intraoperative prophylactic use of antibacterial agents, and no preoperative hair removal were important for reducing postoperative infection.