Risk factors for surgical site infection after minor dermatological surgery

Delpachitra, Meth, Heal, Clare, Banks, Jennifer, Charles, Daniel, Sriharan, Shapavi, and Buttner, Petra (2021) Risk factors for surgical site infection after minor dermatological surgery. Advances in Skin and Wound Care, 34 (1). pp. 43-48.

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Abstract

BACKGROUND: Surgical site infection (SSI) after dermatologic surgery is associated with poor outcomes including increased recovery time, poor cosmesis, and repeat visits to doctors. Prophylactic antibiotics are prescribed to reduce these adverse outcomes. Identifying risk factors for SSI will facilitate judicious antibiotic prophylaxis.

OBJECTIVE: To identify risk factors for SSI after minor dermatologic surgery.

METHODS: Individual patient data from four large randomized controlled trials were combined to increase statistical power. A total of 3,819 adult patients requiring minor skin procedures at a single facility were recruited over a 10-year period. The main outcome measure was SSI.

MAIN RESULTS: A total of 298 infections occurred, resulting in an overall incidence of 7.8% (95% confidence interval [CI], 5.8–9.6), although the incidence varied across the four studies (P = .042). Significant risk factors identified were age (relative risk [RR], 1.01; 95% CI, 1.001–1.020; P = .008), excisions from the upper limbs (RR, 3.03; 95% CI, 1.76–5.22; P = .007) or lower limbs (RR, 3.99; 95% CI, 1.93–8.23; P = .009), and flap/two-layer procedures (RR, 3.23; 95% CI, 1.79–5.85; P = .008). Histology of the excised lesion was not a significant independent risk factor for infection.

CONCLUSIONS: This study demonstrated that patients who were older, underwent complex excisions, or had excisions on an extremity were at higher risk of developing an SSI. An awareness of such risk factors will guide evidence-based and targeted antibiotic prophylaxis.

Item ID: 63008
Item Type: Article (Research - C1)
ISSN: 1538-8654
Keywords: dermatology, surgery, risk, wound, infection
Copyright Information: Published Version: Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved. Accepted Version: authors can self-archive the accepted version of their article on their personal websites or institutional repositories only, without embargo.
Date Deposited: 06 May 2020 00:19
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320226 Surgery @ 50%
42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920117 Skin and Related Disorders @ 50%
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