Risk Factors for Surgical Site Infections in Dermatological Surgery

Abstract

Current literature on risk factors for surgical site infection (SSI) in dermatological surgery in the absence of antibiotic prophylaxis is limited. The aim of this study was to retrospectively evaluate patients presenting for dermatological surgery. A total of 1,977 procedures were reviewed. SSI was clinically suspected in 79 (4.0%) patients and confirmed by culture in 38 (1.9%). Using the strictest definition of SSI (clinical symptoms with positive culture) significantly higher risk of SSI was found for location on the ear (odds ratio (OR) 6.03, 95% confidence interval (95% CI) 2.12-17.15), larger defects (OR 1.08 per cm2 increase, 95% CI 1.03-1.14), closure with flaps (OR 6.35, 95% CI 1.33-30.28) and secondary intention (OR 3.01, 95% CI 1.11-8.13). These characteristics were also associated with higher risk of clinically suspected SSI regardless of culture results with slightly lower ORs. In conclusion, the risk of acquiring a SSI is increased in surgeries performed on the ear, in larger wounds and in defects closed with flaps or healed by secondary intention.

Laser treatments in early wound healing improve scar appearance: a randomized split-wound trial with nonablative fractional laser exposures vs. untreated controls

“…Cutaneous infection developed in three of 32 patients (9%) after excision. In the literature reporting on infection in relation to excisions the rate is typically < 5% . The higher infection rate in our study may be explained by the fact that the lengths of all three infected scars were longer than the mean scar length (4·9 cm) in this study.…”

“…Liu et al . found correspondingly that excisions with larger defect size were significantly more at risk of secondary infection . Another factor is age, as the patients with infection in our study were all aged > 75 years.…”

A Clinical Prediction Model for Surgical Site Infections in Dermatological Surgery

“…In our previous study on SSI after dermatological surgery, specific risk factors that increase the risk of acquiring a SSI have been identified, including the location of the tumour, size of the defect and the method of closure (14). Other patient-, environment-and procedurerelated factors have been studied with conflicting results (1)(2)(3)(4)(5)(6)(7)(8).…”

“…A retrospective cohort study was conducted at the Department of Dermatology, Maastricht University Medical Centre (14). All patients who received surgery under local anaesthesia from April 2014 to April 2015 were included.…”

“…the electronic patient charts. Further details of these characteristics are described in an earlier publication (14). For patients receiving multiple procedures in the study period, only the first procedure was included because observations in the same patients are likely to be correlated.…”