Current Status of Early Surgical Site Infection Following Prosthetic Implantation in Aesthetic and Reconstructive Surgery and Evaluation of Quality Control Improvement Outcomes

To assess the current status of early surgical site infections following prosthetic implantation in plastic surgery across four provincial-level administrative regions in China, and to explore the effectiveness of standardized training for infection prevention and control.

From January to May 2025, an online questionnaire survey was conducted to perform a baseline investigation in medical institutions performing plastic and aesthetic prosthetic implant surgeries in Chongqing, Shaanxi, Jiangxi, and Guizhou provinces. Data were collected on the volume of various types of prosthetic implant surgeries and the corresponding incidence of early surgical site infections. Improvement strategies for the prevention and control of early surgical site infections in prosthetic implant surgeries were jointly developed by the National Medical Quality Control Center for Plastic and Aesthetic Surgery and the National Medical Quality Control Center for Hospital Infection Management, followed by promotion and training. Subsequently, post-implementation data from June to October 2025 were collected from the above regions, and comparisons were made between pre- and post-implementation periods across different regions and surgical categories.

A total of 209 medical institutions were included in the baseline period, with a questionnaire response rate of 99.52% and a total of 7475 prosthetic implantation surgeries. In the post-implementation period, 624 medical institutions were included, with a response rate of 96.00% and a total of 4813 surgeries. The combined proportion of breast prosthesis implantation and nasal/nasal base prosthesis implantation surgeries consistently exceeded 80% across all regions and periods. Regarding the distribution of infection cases, among different types of prosthetic implant surgeries, nasal/nasal base prostheses accounted for the highest proportion, with 57.50%(23/40) at baseline and 62.86% 22/35) post-implementation. The proportion of breast prosthesis infections decreased from 40.00%(16/40) at baseline to 17.14%(6/35) post-implementation. Across different regions, infection cases in Jiangxi (post-implementation)(100%), Guizhou[both baseline(100%) and post-implementation(100%)] were all concentrated in nasal/nasal base prostheses. Shaanxi reported four cases of chin prosthesis infections (22.22%) during the post-implementation period, and Chongqing reported three cases of metal-related infections(27.27%) during the post-implementation period. In terms of infection rates, Chongqing(0.55% vs. 0.26%) and the overall combined regions (0.73% vs. 0.54%) showed higher infection rates post-implementation compared to baseline, while Shaanxi(0.93% vs. 1.05%), Jiangxi(0.29% vs. 1.38%), and Guizhou(0.91% vs. 1.22%) showed lower infection rates post-implementation; none of these differences reached statistical significance (all P > 0.05). The infection rate for metal-related prostheses increased significantly in Chongqing(1.43% vs. 0, P=0.04) and in the overall combined regions(1.22% vs. 0, P=0.04), while no significant differences were observed for other surgical categories within the same regions (all P > 0.05).

Breast prostheses and nasal/nasal base prostheses currently represent the main types of implants used in prosthetic implantation surgeries. The improvement strategies implemented in this study were associated with decreased early surgical site infection rates in multiple regions, suggesting that these strategies provide clinical insights for the prevention and control of early infections following prosthetic implantation surgeries in China.