Предиктивные факторы инфекционных осложнений при одномоментной и отсроченной реконструкции у больных раком молочной железы

Topuzov, E. E., Skvortsov, V. A., Orlova, R. V., Lemeshevskaya, O. I., & Ivanov, S. V. (2026). Predictive Factors for Infectious Complications Following Immediate and Delayed Reconstruction in Breast Cancer Patients. Voprosy Onkologii, 72(3), OF–2668. https://doi.org/10.37469/0507-3758-2026-72-3-OF-2668

Abstract

Introduction. The number of breast alloplastic reconstructive surgeries is rising, along with a concurrent increase in complications. Despite numerous international studies, there is no consensus on the risk factors for infectious complications.

Aim. To find predictors of infectious complications in groups of immediate and delayed breast reconstruction.

Materials and Methods. This retrospective cohort study included 267 patients who underwent immediate or delayed breast reconstruction using an expander and/or implant at the St. Petersburg City Clinical Oncological Dispensary between 2014 and 2021. The primary endpoint was the occurrence of an infectious complication, defined according to CDC/NHSN criteria for surgical site infections. Patient demographics, medical history, disease characteristics, treatments received, and surgical details were analyzed.

Results. Infectious complications developed in 19 of 141 patients (13.5 %) after immediate reconstruction and 13 of 128 patients (10.2 %) after delayed reconstruction. Multivariate binary logistic regression models, constructed with factors selected from univariate analyses, identified a pinch-test result of 0–5 mm as a significant predictor in both groups (Immediate: aOR = 4.968, 95 % CI 1.702–14.498, p=0.003; Delayed: aOR = 4.717, 95 % CI 1.196–18.597, p = 0.027). In the immediate reconstruction group, smoking (aOR = 8.887, 95 % CI 1.433–55.119, p = 0.019) and higher body mass index (BMI; aOR = 1.161 per unit, 95 % CI 1.018–1.323, p = 0.026) were independent risk factors. In the delayed reconstruction group, adjuvant radiotherapy prior to reconstruction was a significant risk factor (aOR = 18.090, 95 % CI 1.594–52.322, p = 0.019).

Conclusion. A pinch-test result of 0–5 mm is an independent predictor of infectious complications for both the groups. Additional, risk factors include smoking and higher BMI for immediate reconstruction, and adjuvant radiotherapy for delayed reconstruction.

https://doi.org/10.37469/0507-3758-2026-72-3-OF-2668

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