Surgical site infections after microscopically controlled skin surgery in immunocompromised patients: a retrospective two-center cohort study.
Arch Dermatol Res
; 312(7): 491-499, 2020 Sep.
Article
en En
| MEDLINE
| ID: mdl-32009218
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.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
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Infección de la Herida Quirúrgica
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Cirugía de Mohs
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Inmunosupresores
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Antibacterianos
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Arch Dermatol Res
Año:
2020
Tipo del documento:
Article
País de afiliación:
Alemania