A Clinical Prediction Model for Surgical Site Infections in Dermatological Surgery

Abstract

To adequately identify patients at risk for surgical site infection in dermatological surgery and effectively prescribe antibiotic prophylaxis, a prediction model may be helpful. Such a model was developed using data from 1,407 patients who underwent dermatological surgery without antibiotic prophylaxis. The multivariable logistic regression model included type of closure, tumour location and defect size as risk factors. Bootstrapping was used for internal validation. The overall performance of the model was good, with an area under the curve of 84.1%. The decision curve analysis showed that the model is potentially useful if one is willing to treat more than 8 patients with antibiotic prophylaxis to avoid one infection. For those who prefer more restrictive use of antibiotic prophylaxis, a default strategy of treating no patients at all with prophylaxis would be the best choice. External validation of the model is required before it can be widely applied.

Postoperative complications in dermatological patients undergoing microscopically controlled surgery in inpatient setting (next‐day surgery): A single‐center epidemiological study

“…To the best of our knowledge, the present work is one of a small number of investigations that perform a population‐based analysis of surgical complications after microscopically controlled (next‐day) skin surgery [7,15]. Similarly to previous studies that explored both Mohs surgery and microscopically controlled skin surgery, our data suggest a relatively low rate of surgical complications after microscopically controlled skin surgery [4,7--10,15--19]. In the present investigation, bleeding, surgical site infections, and necrosis of the flap or graft occurred at a rate of 3.8 %, 5.1 %, and 1.7 %, respectively.…”

“…Surgical site infections rates also vary between previous studies depending on the surgical approach [1--7,15--17,19,21--23]. For Mohs surgery, SSI rates are predominantly low and lie within the range from 1.47 % to over 8 % [3--6,16--19,21--23]. Thus, the SSI rate of 5.1 % reported in our investigation for microscopically controlled skin surgery is within the range outlined for Mohs surgery.…”

Antimicrobial stewardship program for gastrointestinal surgeries at a Vietnamese tertiary hospital

“…Given the effectiveness of ASPi at our hospital, we built and cross-validated a predictive model to help identify patients with a high risk of SSIs so that physicians could timely apply appropriate prevention measures. This approach was quite similar to some other prediction models (27)(28)(29), which also yielded good estimations. Based on our model's performance, we estimated our model could further reduce healthcare costs substantially.…”

Postoperative Komplikationen bei dermatochirurgischen Patienten im Rahmen der stationären mikroskopisch‐kontrollierten Chirurgie: Eine monozentrische epidemiologische Studie

“…Nach unserem besten Wissen stellt die vorliegende Arbeit eine der wenigen vorhandenen Untersuchungen zum Thema postoperativer Komplikationen im Rahmen von stationären dermatochirurgischen Eingriffen dar [7,15]. Ähnlich wie die aktuelle wissenschaftliche Literatur, in der sowohl die Mohs-Chirurgie als auch die stationäre mikroskopisch-kontrollierte Hautchirurgie (next-day surgery) untersucht wurden, deuten unsere Daten auf relativ geringe Komplikationsraten nach stationär durchgeführter mikroskopisch-kontrollierter Hautchirurgie hin [4,7,10,[15][16][17][18][19]. In der vorliegenden Untersuchung traten Blutungskomplikationen, postoperative Wundinfektionen und Nekrosen des Lappens oder des Transplantats mit einer Rate von jeweils 3,8 %, 5,1 % beziehungsweise 1,7 % auf.…”

“…Die in den wissenschaftlichen Publikationen berichteten SSI‐Raten variieren ebenfalls in Abhängigkeit von den verwendeten dermatochirurgischen Methoden [1–7, 15–17, 19, 21–23]. Bei der ambulant durchgeführten Mohs‐Chirurgie (same‐day surgery) sind die SSI‐Raten grundsätzlich niedrig und liegen im Bereich zwischen 1,47 % und über 8 % [3–6, 16–19, 21–23]. Somit liegt die in unserer Kohorte für stationär durchgeführte chirurgische Eingriffe (next‐day surgery) ermittelte SSI‐Rate mit 5,1 % innerhalb des für die Mohs‐Chirurgie angegebenen Bereichs.…”