Seasonal Impact on Surgical Site Infections in Body Contouring Surgery: A Retrospective Cohort Study of 602 Patients Over a Period of 6 Years

Purpose: Postoperative Surgical Site Infections (SSI) are severe complications following body-contouring-surgery (BCS). Here we evaluate if SSI rates are influenced by higher temperatures during the summer season. Patients and Methods: We enrolled 602 patients who underwent BCS between 2009 and 2015 in a retrospective cohort study. Data collected included demographics, surgical data and postoperative outcome. BCS procedures included lower and upper-bodylift, abdominoplasty, breast-reduction, mastopexy, brachioplasty and thigh-lift. Infection rates were calculated on a seasonal basis and compared using Fisher's-exact test and logistic-regression-analysis. Results: There were 136 patients (125 women; 11 men) in the warm season (June-August; with an average temperature of 67.622°F (19.79°C) and 466 patients (438 women; 28 men) in the cold seasons group (September-May; with an average temperature of 45.45 °F (7.47°C)). The composition of the study cohorts was comparable. Average age was 40 years and average body mass index was 27. From a total of 602 patients we observed 33 SSIs, representing a rate of 5.48%. A statistically significant rise of postoperative SSIs could be detected during summer (10.29% vs. 4.08%, p=0.0071) representing an increase of 150%. Additionally, a logistic regression analysis determined 'season' as the strongest predictor for SSIs with a risk exaltation of 2.693 times in the warm season. Conclusion: BCS are elective procedures making careful risk consideration an absolute prerequisite. We demonstrate a significantly increased infection risk during summer and establish a causal link between the warm season and SSI accumulation. Consequently, preoperative patient information and operative planning should be adjusted accordingly. * These authors contributed equally to this work None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. CORRESPONDING AUTHOR: DR. GEORG M HUEMER, M.SC. MBA, Section of Plastic and Reconstructive Surgery- Kepler University Hospital Linz, Krankenhausstrasse 9, 4020 Linz- Austria. Conflict of Interest:The authors have no financial interest to declare in relation to the content of this article. ©2018American Society of Plastic Surgeons

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