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Schlager, Justin Gabriel; Patzer, Kathrin; Wallmichrath, Jens; French, Lars E.; Kunrad, Elena; Schlingmann, Sophia; Stiefel, Daniel; Kendziora, Benjamin; Hartmann, Daniela (2023): Surgical site infection in skin surgery—An observational study. International Wound Journal. ISSN 1742-4801

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International Wound Journal - 2023 - Schlager - Surgical site infection in skin surgery An observational study.pdf

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Surgical site infection (SSI) has a significant impact on patients’ morbidity and aesthetic results.

To identify risk factors for SSI in dermatologic surgery.

Patients and Methods
This prospective, single-centre, observational study was performed between August 2020 and May 2021. Patients that presented for dermatologic surgery were included and monitored for the occurrence of SSI. For statistical analysis, we used a mixed effects logistic regression model.

Overall, 767 patients with 1272 surgical wounds were included in the analysis. The incidence of SSI was 6.1%. Significant risk factors for wound infection were defect size over 10cm2 (OR 3.64, 95% confidence interval [CI] 1.80–7.35), surgery of cutaneous malignancy (OR 2.96, CI 1.41–6.24), postoperative bleeding (OR 4.63, CI 1.58–13.53), delayed defect closure by local skin flap (OR 2.67, CI 1.13–6.34) and localisation of surgery to the ear (OR 7.75, CI 2.07–28.99). Wound localisation in the lower extremities showed a trend towards significance (OR 3.16, CI 0.90–11.09). Patient-related factors, such as gender, age, diabetes, or immunosuppression, did not show a statistically significant association with postoperative infection.

Large defects, surgery of cutaneous malignancy, postoperative bleeding, and delayed flap closure increase the risk for SSI. High-risk locations are the ears and lower extremities.

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