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Complications and risk factors of punch biopsy: A retrospective large-scale study
Yukiko Yasui1, Hiroshi Kato1, Takao Oda2
1Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Insights
Punch biopsy complications are rare, with bleeding being the most common. Key risk factors for bleeding include biopsy site location and low platelet count, necessitating careful patient selection and pre-procedure evaluation.
Area of Science:
- Dermatology
- Surgical Procedures
Background:
- Punch biopsy is a common dermatologic procedure.
- Understanding its complication risks is crucial for patient safety.
Purpose of the Study:
- To analyze the risk factors and proportions of complications associated with punch biopsy.
- To identify specific patient and procedural factors that increase complication risk.
Main Methods:
- Retrospective analysis of 1294 patients undergoing punch biopsy between November 2018 and November 2020.
- Statistical analysis to determine the odds ratios for identified risk factors.
Main Results:
- Postoperative bleeding (0.9%) was the most frequent complication.
- Wound infection (0.2%), skin damage (0.2%), and vagal reflex (0.1%) were less common.
- Biopsy site outside the trunk (OR 4.60) and low platelet count (<150,000/μL) (OR 2.82) were significant risk factors for bleeding.
Conclusions:
- Pre-procedure assessment of platelet count and consideration of biopsy site are important for minimizing bleeding risk.
- Informed consent should include a thorough explanation of potential punch biopsy complications.
- Appropriate patient selection and determination of suture necessity can enhance procedural safety.
Abstract:
The authors analyzed the risk factors of punch biopsy by investigating the complications of the technique and their proportions. Patients who underwent punch biopsy in a dermatology clinic between November 2018 and November 2020 (n = 1294; mean age, 62.3 years; 540 men and 754 women) were enrolled in the current study. The most common complication was postoperative bleeding (0.9%). Wound infection (0.2%), surrounding skin damage (0.2%), and vagal reflex (0.1%) were also observed. The main risk factors for bleeding following biopsy were location of biopsy site outside of the trunk (odds ratio [OR], 4.60 [95% CI, 2.65-8.00]; p < 0.001) and platelet count lower than 150 000/μL (OR, 2.82 [95% CI, 1.69-4.73]; p < 0.001). When performing a punch biopsy, an adequate explanation of the risks and complications should be provided before obtaining informed consent. Further, blood sampling tests should be performed in advance and the types of cases that may require wound suture should be appropriately determined.
