Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics

Dixon, Anthony J., Dixon, Mary P., Askew, Deborah A. and Wilkinson, David (2006) Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics. Dermatologic Surgery, 32 6: 819-827. doi:10.1111/j.1524-4725.2006.32167.x


Author Dixon, Anthony J.
Dixon, Mary P.
Askew, Deborah A.
Wilkinson, David
Title Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics
Journal name Dermatologic Surgery   Check publisher's open access policy
ISSN 1076-0512
Publication date 2006
Sub-type Article (original research)
DOI 10.1111/j.1524-4725.2006.32167.x
Volume 32
Issue 6
Start page 819
End page 827
Total pages 11
Editor Dr William P. Coleman III
Place of publication United States
Publisher Blackwell Publishing, Inc.
Collection year 2006
Language eng
Subject C1
321002 Dermatology
730117 Skin and related disorders
110304 Dermatology
1103 Clinical Sciences
Formatted abstract
OBJECTIVE The study aimed to identify wound sites/procedures where infection incidence was over 5%, such that these circumstances may warrant wound infection antibiotic prophylaxis.

METHOD We undertook a 3-year prospective study of 5,091 lesions (predominantly nonmelanoma skin cancer) treated on 2,424 patients from July 2002 to June 2005. No patient was given prophylactic antibiotics, and no patient ceased warfarin or aspirin.

RESULTS Overall infection incidence was 1.47%. Individual procedures had the following infection incidence: curettage 0.73% (3/412); skin flap repairs 2.94% (47/1601); simple excision and closure 0.54% (16/2974); skin grafts 8.70% (6/69); and wedge excision 8.57% (3/35). Analysis of regions of the body demonstrated that surgery below the knee (n=448) had an infection incidence of 6.92% (31/448) (p<.0001). Subanalysis demonstrated that all regions below the knee were at high infection risk. Elsewhere, groin excisional surgery had an infection incidence of 10% (1/10) (p=.027). No other body site demonstrated an infection incidence beyond 5% of statistical significance. Procedures on the face demonstrated an infection incidence of 0.81% (18/2,209). Diabetic patients, those on warfarin and/or aspirin, and smokers showed no difference in infection incidence.

CONCLUSION Based on a prediction of infection incidence over 5%, the following cutaneous oncologic procedures warrant consideration of oral antibiotic wound infection prophylaxis: all procedures below the knee, wedge excisions of lip and ear, all skin grafts, and lesions in the groin. Other than under these circumstances, surgery to the nose, ear, fingers, lips, skin flap surgery, and surgery on diabetics, smokers, and those on anticoagulants have previously been considered for wound infection prophylaxis but do not warrant such intervention based on our data.
Keyword Dermatology
Surgery
Bypass Graft-surgery
Risk-factors
Cutaneous Surgery
Complications
Rates
Flap
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 09:07:40 EST