Abstract

Background

Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection.

Methods

A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome.

Results

A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p < 0.001), larger volume of expander (200–400 ml vs <200 ml; OR, 1.74; p = 0.032; >400 ml vs <200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure.

Conclusions

The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of <1 year, expander volume of >200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

中文翻译：

---

瘢痕重建中组织扩张器感染的危险因素：2374 例连续病例的回顾性队列研究

摘要

背景

由于其出色的临床效果，组织扩张用于疤痕重建；然而，组织扩张引起的并发症阻碍了修复。感染被认为是组织扩张的主要并发症。本研究旨在分析扩张器感染的围手术期危险因素。

方法

一项为期 10 年的大型回顾性单机构观察性研究进行。该研究连续招募了接受组织扩张以进行疤痕重建的患者。评估人口统计学、病因学数据、扩张器相关特征和术后感染。进行单变量和多变量逻辑回归分析以确定扩张器感染的危险因素。此外，我们对感染导致的治疗失败作为结果进行了敏感性分析。

结果

共评估了 2374 个扩张器和 148 例扩张器感染。14例扩张器因感染导致治疗失败。多变量逻辑回归分析发现，病程≤1 年（优势比 (OR)，2.07；p  < 0.001），扩张器体积更大（200-400 ml vs <200 ml；OR，1.74；p  = 0.032；>400 ml vs <200 ml；OR，1.76；p  = 0.049）、肢体位置（OR，2.22；p  = 0.023）和血肿清除（OR，2.17；p  = 0.049）与扩张器感染的高可能性相关。病程≤1 年（OR，3.88；p  = 0.015）和血肿清除（OR，10.35；p = 0.001) 与治疗失败的高风险密切相关。

结论

接受瘢痕重建的患者扩张器感染率为6.2%。病程<1年、扩张器体积>200 ml、肢体位置和术后血肿清除是扩张器感染的独立危险因素。