Eighty percent of all surgical-site infections that occur after face lifts are caused by methicillin-resistant Staphylococcus aureus (MRSA), according to a study conducted by researchers from the Lennox Hill-Manhattan Eye, Ear, and Throat Hospital and published in the Archives of Facial Plastic Surgery.
MRSA, an antibiotic-resistant form of the common “staph” infection, has already become the leading organism responsible for skin, soft tissue, and surgical-site infections in the United States in general. Due to its higher virulence and resistance to the most common first-line antibiotics, MRSA kills three times as many patients as more conventional S. aureus infections.
In the current study, researchers sought to determine if MRSA infection is as prevalent among post-face-lift infections as among surgical-site infections in general. Only one prior study, conducted more than 10 years ago, has been conducted on surgical-site infection rates for face lifts..
The researchers reviewed the medical charts of 780 patients who had undergone a deep-plane rhytidectomy between January 2001 and January 2007. All patients had been treated by a single surgeon at the same outpatient center. Some of the patients also had other cosmetic surgical procedures performed at the same time.
All patients underwent the same measures to prevent infection, including showering and washing their hair with chlorhexidine before the surgery, having their faces scrubbed with chlorhexidine and povidone-iodine immediately before the incision, and getting an intravenous dose of cefazolin sodium. Patients also took oral antibiotics for seven days after the procedure.
Probably due to these protective measures, the overall rate of infection was very low, at 0.6 percent. Eighty percent of those developing an infection, however, became infected with MRSA.
“For surgical site infections, the facial plastic surgeon should have a high suspicion for MRSA as the causative pathogen,” the researchers wrote.
The researchers suggested that the high rate of MRSA infection might arise from the fact that antibiotic-sensitive infections tend to be eliminated by the prophylactic antibiotic measures that patients typically undergo.