Postoperative Complications and Risk Factors in Skin Tumor Excision With Simple Suturing Under Local Anesthesia: A...

Area of Science:

• Dermatology
• Surgical Oncology
• Evidence-Based Medicine

Background:

• Skin tumor excision under local anesthesia with simple suturing is a common outpatient procedure.
• Postoperative complications like wound dehiscence, infection, and contact dermatitis can impact patient outcomes and healthcare resources.
• Limited data exist on complication rates and risk factors for these procedures without reconstructive techniques.

Purpose of the Study:

• To retrospectively analyze complication rates and identify risk factors for skin tumor excision with simple closure.
• To evaluate the impact of intraoperative antibiotic use on postoperative complications.
• To provide evidence for risk assessment and perioperative management in dermatological surgery.

Main Methods:

• Retrospective analysis of 1291 patients undergoing skin tumor excision and simple closure across three Japanese institutions (Jan 2021 - Nov 2024).
• Complications defined as adverse events requiring medical intervention within 30 days postoperatively.
• Logistic regression analysis used to identify independent risk factors, with cutoff values determined by ROC curves.

Main Results:

• A total of 168 complications (12.7%) were observed in 164 patients.
• Most common complications included contact dermatitis (3.7%), wound dehiscence (3.3%), and surgical site infection (2.9%).
• Significant risk factors identified: tumor size ≥ 10 mm (OR 1.52), operative time ≥ 38 min (OR 1.84), and surgeon experience ≥ 10 years (OR 1.64).
• Intraoperative antibiotic use significantly reduced overall complication risk (OR 0.29) and surgical site infections (OR 0.32).

Conclusions:

• Tumor size, operative time, and surgeon experience are key predictors of postoperative complications in skin tumor surgery.
• Prophylactic intraoperative antibiotics are effective in reducing surgical site infections and should be considered for high-risk patients.
• Findings support evidence-based risk assessment and perioperative management strategies for dermatological surgery.