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Postoperative infection after excisional toenail matrixectomy: a retrospective clinical audit
1Podiatry Outpatients, Repatriation General Hospital, Daw Park, South Australia, Australia. arusmir@gmail.com
Background:
Excisional toenail matrixectomies are performed on the area of the foot that has been reported to have the highest concentration of resident microorganisms. A retrospective infection audit was performed to identify whether this unique area of the foot was more susceptible to postoperative infection.
Methods:
A retrospective audit reviewing the postoperative infection rate over a 6-year period after excisional nail matrixectomy in 111 patients was undertaken.
Results:
The postoperative infection rate was found to be high (18.9%) relative to that of clean orthopedic foot and ankle surgery (0.5%-6.5%).
Conclusions:
The unique concentration of resident microbes found in the nail folds could help explain the high rate of postoperative infections identified in this study. This may provide some argument to classify excisional nail matrixectomy as clean-contaminated surgery and, thus, warrant routine antibiotic prophylaxis. Further research is recommended to confirm the results of this study and to determine whether appropriately timed oral antibiotic prophylaxis will reduce the infection rate after nail surgery.
Insights
Excisional toenail matrixectomy surgery resulted in a high postoperative infection rate (18.9%). This finding suggests the procedure may require antibiotic prophylaxis due to high microbial concentration in nail folds.
Area of Science:
- Podiatric surgery
- Infectious disease
- Microbiology
Background:
- Excisional toenail matrixectomies target areas with high microbial concentrations.
- A retrospective audit investigated infection susceptibility in this foot region.
Purpose of the Study:
- To determine the postoperative infection rate following excisional nail matrixectomy.
- To assess if the nail fold's microbial load increases infection risk.
Main Methods:
- A 6-year retrospective audit of 111 patients undergoing excisional nail matrixectomy.
- Analysis of postoperative infection rates compared to clean orthopedic foot and ankle surgery.
Main Results:
- The study identified a high postoperative infection rate of 18.9%.
- This rate significantly exceeds the typical 0.5%-6.5% for clean orthopedic foot and ankle procedures.
Conclusions:
- High resident microbial counts in nail folds may explain elevated infection rates.
- Excisional nail matrixectomy might be classified as clean-contaminated surgery, potentially necessitating antibiotic prophylaxis.
- Further research is recommended to validate these findings and assess the efficacy of antibiotic prophylaxis.
