Procedure-Related Risk Factors for Surgical Site Infection in Dermatologic Surgery. Issue 10 (15th October 2022)

• Record Type: Journal Article
• Authors: Schlager, Justin Gabriel; Hartmann, Daniela; Ruiz San Jose, Virginia; Patzer, Kathrin; French, Lars E.; Kendziora, Benjamin
• Is Part Of: Dermatologic surgery. Volume 48:Issue 10(2022)
• Page Start: 1046
• Page End: 1050
• Publication Date: 2022-10-15
• Subjects: Skin -- Surgery -- Periodicals; Skin -- Diseases -- Surgery -- Periodicals; 617.477
• DOI: 10.1097/DSS.0000000000003546
• Languages: English
• ISSNs: 1076-0512

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract : BACKGROUND: Identifying risk factors is essential for preventing surgical site infections (SSIs) in dermatologic surgery. OBJECTIVE: To analyze whether specific procedure-related factors are associated with SSI. METHODS: This systematic review of the literature included MEDLINE, EMBASE, CENTRAL, and trial registers. The Newcastle–Ottawa Scale was used for risk bias assessment. If suitable, the authors calculated risk factors and performed meta-analysis using random effects models. Otherwise, data were summarized narratively. RESULTS: Fifteen observational studies assessing 25, 928 surgical procedures were included. Seven showed good, 2 fair, and 6 poor study quality. Local flaps (risk ratio [RR] 3.26, 95% confidence intervall [CI] 1.92–5.53) and skin grafting (RR 2.95, 95% CI 1.37–6.34) were associated with higher SSI rates. Simple wound closure had a significantly lower infection risk (RR 0.34, 95% CI 0.25–0.46). Second intention healing showed no association with SSI (RR 1.82, 95% CI 0.40–8.35). Delayed wound closure may not affect the SSI rate. The risk for infection may increase with the degree of preoperative contamination. There is limited evidence whether excisions >20 mm or surgical drains are linked to SSI. CONCLUSION: Local flaps, skin grafting, and severely contaminated surgical sites have a higher risk for SSI. Second intention healing and probably delayed wound closure are not associated with postoperative wound infection.