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Postoperative complications in dermatological patients undergoing microscopically controlled surgery in inpatient

Inga Artamonova1,2, Laurenz Schmitt2, Amir S Yazdi2

  • 1Department of Orthopedics and Trauma Surgery, Marienhospital Brühl, Brühl, Germany.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|June 30, 2020
PubMed
Abstract

Insights

Complication rates for dermatological surgery performed in German hospitals are low, similar to Mohs surgery. Bleeding is a significant risk factor for surgical site infections and necrosis, but diabetes and immunosuppression are not.

Area of Science:

  • Dermatology
  • Surgical Oncology
  • Infectious Disease

Background:

  • Complications of dermatological surgery, including surgical site infections (SSI), bleeding, and necrosis, are well-documented for Mohs surgery (same-day).
  • Limited data exist on complication rates for microscopically controlled surgery as practiced in German hospitals (next-day surgery).

Purpose of the Study:

  • To analyze postoperative outcomes and complication rates of microscopically controlled surgery in a German hospital setting.
  • To compare complication rates with those reported for Mohs surgery.

Main Methods:

  • Retrospective analysis of patient records from the Department of Dermatology and Allergology at a German University Hospital.
  • Inclusion of all patients undergoing microscopically controlled surgery during 2017.

Main Results:

  • 528 procedures were performed on 319 patients. Bleeding occurred in 3.8%, necrosis in 1.7%, and SSI in 5.1% of cases.
  • Bleeding was a significant risk factor for SSI (p=0.01).
  • Bleeding, SSI, and full-thickness graft closure were significant risk factors for necrosis (p<0.05). Diabetes and immunosuppression were not significant risk factors.

Conclusions:

  • Complication rates for next-day microscopically controlled surgery are low and comparable to same-day Mohs surgery.
  • Evidence-based recommendations for Mohs surgery may be applicable to German inpatient dermatologic surgery.
  • Further prospective studies with larger cohorts are needed for specific recommendations for next-day surgery.

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