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Surgical site infections after microscopically controlled skin surgery in immunocompromised patients: a retrospective two-center cohort study.
- Source :
-
Archives of dermatological research [Arch Dermatol Res] 2020 Sep; Vol. 312 (7), pp. 491-499. Date of Electronic Publication: 2020 Feb 03. - Publication Year :
- 2020
-
Abstract
- The data on the risk of surgical site infections (SSI) after skin surgery in patients undergoing immunosuppressive treatment are limited and the results of the existing single-center studies are controversial. At the same time, perioperative antibiotic prophylaxis (PAP) for immunocompromised patients seems to be overused. We performed a retrospective analysis of the SSI rates after extensive dermatosurgical procedures performed from January 2017 to December 2017 in patients with impaired immune status due to a hematological disorder or immunosuppressive treatment at two German dermatosurgical centers. The SSI rate in immunocompromised patients was 6.7%. The independent risk factors for SSI found in the studied population were the occurrence of bleeding after one of the surgical stages and the use of oral anticoagulation with two different agents (the combination of acetylsalicylic acid and a direct oral anticoagulant). 44.4% (4/9) of the procedures complicated with an SSI involved wound closure with a skin flap, which was statistically significant (p = 0.041). Other risk factors identified were older age of the patients and increased duration of hospitalization (p < 0.05). Localization of the surgical site, number of surgical stages required for tumor clearance, and diabetes mellitus were not found to be statistically significant risk factors for occurrence of SSI in the studied population. SSI rates in immunocompromised patients undergoing skin surgery are low; therefore, we recommend against routine use of PAP for this cohort.
- Subjects :
- Age Factors
Aged
Antibiotic Prophylaxis statistics & numerical data
Anticoagulants adverse effects
Female
Follow-Up Studies
Humans
Immunocompromised Host
Male
Postoperative Hemorrhage epidemiology
Retrospective Studies
Risk Factors
Skin Neoplasms immunology
Surgical Flaps adverse effects
Surgical Flaps transplantation
Surgical Wound Infection etiology
Surgical Wound Infection prevention & control
Anti-Bacterial Agents therapeutic use
Immunosuppressive Agents adverse effects
Mohs Surgery adverse effects
Skin Neoplasms therapy
Surgical Wound Infection epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-069X
- Volume :
- 312
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Archives of dermatological research
- Publication Type :
- Academic Journal
- Accession number :
- 32009218
- Full Text :
- https://doi.org/10.1007/s00403-020-02035-8