Audit of admissions to dermatology beds in Greater Manchester

Helbling, Ignacio Marcelo; Ferguson, Jennifer; McKenna, Malachi J.; Muston, Haydn L.

doi:10.1046/j.1365-2230.2002.01073.x

Cited by 15 publications

(18 citation statements)

References 5 publications

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“…5,[7][8][9]14 Dermatology inpatients differ significantly from outpatients in that inpatients are more likely to have widespread skin disease possibly colonized with S aureus to be systemically unwell, and to require intensive topical therapy and observation. 2 It is, therefore, not surprising that the rate of infectious complications in these studies of excisional surgery is far lower than in our present study. 5 The preoperative state of the skin is clearly important.…”

Section: Commentcontrasting

confidence: 53%

Wound Complications Following Diagnostic Skin Biopsies in Dermatology Inpatients

Wahie¹,

Lawrence²

2007

Arch Dermatol

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To prospectively determine the wound complication rate for dermatology inpatients undergoing diagnostic skin biopsies during their admission and to determine significant host and procedural risk factors.Design: Prospective assessment, by a single observer, of 100 postdiagnostic skin biopsy wounds in dermatology inpatients. The following data were recorded for each patient: age and sex, presence of comorbidities, smoking status, dermatologic diagnosis, use of immunosuppressive or antibiotic therapy, place of biopsy (whether in the operation theater or in the ward), grade of physician performing biopsy, biopsy site on the body, type of biopsy (whether elliptical incision, punch, shave, or curettage), and wound closure technique.Main Outcome Measure: Wounds were designated as having had no complication or as being complicated by infection, dehiscence, and/or hematoma.Setting: A dedicated dermatology inpatient ward in a university teaching hospital.Results: Wound complications occurred in 29 (29%) biopsies, 27 (93%) of which were the result of wound infection. Complications occurred significantly more frequently when biopsies were performed below the waist compared with above the waist (PϽ.02), in the ward compared with the outpatient operating theater (P Ͻ.001), in smokers compared with nonsmokers (P Ͻ.001), and in those taking corticosteroids compared with those who were not (PϽ .001). In addition, elliptical incisional biopsies developed complications more frequently when subcutaneous sutures were not used compared with when they had been used (P Ͻ.001).Conclusions: This study has demonstrated a high rate of wound complications after diagnostic dermatologic surgery on dermatology inpatients with significant host and procedural risk factors. These findings are relevant for other centers with inpatient units where diagnostic biopsies are performed.

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Section: Commentcontrasting

confidence: 53%

Wound Complications Following Diagnostic Skin Biopsies in Dermatology Inpatients

Wahie¹,

Lawrence²

2007

Arch Dermatol

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“…The mean age of the patients was similar to that reported in a study by Jessop et al (34.1years) 7 and lower than that reported by Hasan et al(44 years) 5 ,and Hebling et al (53 years). 8 Most common reason for admission in our study was drug reaction, which comprised 21.6% of all new admissions whereas it was 5.82% in an Iranian study. 5 The reason behind this could be more easily available drugs over the counter and the overuse of the drugs in the community by health care worker for trivial ailments.…”

Section: Discussionmentioning

confidence: 49%

In patient dermatology: characteristics of patients and admissions in Tribhuvan University (TU) Teaching Hospital

Parajuli

Paudel

Pokhrel

2013

Nepal J Dermatol Venereol & Leprol

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Introduction Inpatient dermatology has been described only in few countries. Characteristics of inpatient might be important in the evaluation of its usefulness and best use of dermatological beds for the care of the patient ObjectivesTo describe inpatient activity in dermatology department of TU teaching hospital, Kathmandu, Nepal. MethodsThis was cross-sectional retrospective study in a single hospital. All patients admitted from (15 th April 2008 to 14 th April 2012) in the dermatological ward were taken from the admission and discharge record of the department. The data was analysed for the number of admissions, demographic profile of patients, clinical diagnosis, readmission rates, length of hospital stay and outcome ResultsThere were a total of 505 admissions in a four years period. Out of this 283(56%) were new admissions and 222(44%) were readmissions. The most common diagnosis among new admissions was drug reaction (21.6%), followed by immunobullous diseases (14.5%) and connective tissue diseases (14.1%). The other most common reasons for admissions were infections, erythroderma, eczema, erythema multiforme, urticaria and vasculitis. The mean length of stay in the hospital was 6.83 ± 6.150 days. Out of 505 admissions there were 487(96.4%) discharges after improvement, 12(2.4%) cases were transferred to other wards and ICU for management. There were 4(0.8%) mortalities in this 4 years period. ConclusionImmunobullous diseases, connective tissue diseases, drug reactions, infections, erythroderma, eczema, psoriasis, erythema multiforme, urticaria and vasculitis were the top 10 conditions for the admission. Policy makers could take these data as evidence to allocate beds for Dermatological patients for better management of these subsets of patients.

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“…Nevertheless, inpatient management has been shown to be effective, with documented improvement in objective measures of disease severity and quality of life. [4][5][6][7] Furthermore, admission is still required for that minor-ity of patients with psoriasis that fails to respond to outpatient measures or is of such severity that inpatient nursing is required.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic diseases such as psoriasis which were formerly routinely treated by hospital admission can now be managed successfully in an outpatient setting, 1–3 to the benefit of patients and the health economy. Nevertheless, inpatient management has been shown to be effective, with documented improvement in objective measures of disease severity and quality of life 4–7 . Furthermore, admission is still required for that minority of patients with psoriasis that fails to respond to outpatient measures or is of such severity that inpatient nursing is required.…”

mentioning

confidence: 99%

Inpatient management of psoriasis: a multicentre service review to establish national admission standards

Woods

Rutter

Gardner

et al. 2007

British Journal of Dermatology

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Audit of admissions to dermatology beds in Greater Manchester

Cited by 15 publications

References 5 publications

Wound Complications Following Diagnostic Skin Biopsies in Dermatology Inpatients

Wound Complications Following Diagnostic Skin Biopsies in Dermatology Inpatients

In patient dermatology: characteristics of patients and admissions in Tribhuvan University (TU) Teaching Hospital

Inpatient management of psoriasis: a multicentre service review to establish national admission standards

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