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Risk Factors for Surgical Site Infections in Dermatological Surgery
Xiaomeng Liu1, Melissa Sprengers, Patty J Nelemans
1Department of Dermatology, Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, The Netherlands. xmxmliu@gmail.com.
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.
Insights
Surgical site infections (SSI) risk factors in dermatological surgery without antibiotics include ear location, larger wound size, flap closure, and secondary intention healing. These factors increase the likelihood of developing an SSI.
Area of Science:
- Dermatology
- Surgical Infections
- Wound Healing
Background:
- Limited current literature exists on risk factors for surgical site infection (SSI) in dermatological surgery without antibiotic prophylaxis.
- Understanding these risk factors is crucial for preventing post-operative complications.
Purpose of the Study:
- To retrospectively evaluate risk factors associated with surgical site infections (SSI) in dermatological surgery.
- To identify specific surgical characteristics that increase the risk of SSI in the absence of antibiotic prophylaxis.
Main Methods:
- Retrospective review of 1,977 dermatological surgery procedures.
- Analysis of clinically suspected and culture-confirmed surgical site infections (SSI).
- Statistical analysis using odds ratios (OR) and 95% confidence intervals (95% CI) to determine risk factors.
Main Results:
- A surgical site infection (SSI) rate of 1.9% was confirmed by culture.
- Significant risk factors for SSI included ear location (OR 6.03), larger defect size (OR 1.08 per cm²), flap closure (OR 6.35), and secondary intention healing (OR 3.01).
- These factors also correlated with clinically suspected SSI, regardless of culture results.
Conclusions:
- The risk of surgical site infection (SSI) in dermatological surgery is elevated for procedures on the ear.
- Larger wound sizes and closure methods involving flaps or secondary intention healing are associated with increased SSI risk.
- These findings highlight key areas for targeted prevention strategies in dermatological surgery.
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