Schmitt Adam, DePry Jennifer, Tsai Sheena, Bordeaux Jeremy
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Las Vegas Skin and Cancer Clinics, Las Vegas, Nevada.
Dermatol Surg. 2018 Dec;44(12):1537-1546. doi: 10.1097/DSS.0000000000001605.
As the number of cutaneous surgeries continues to increase, it is important to evaluate the safety of dermatologic surgery in the outpatient setting.
The authors sought to determine postoperative bleeding, infection, dehiscence, and necrosis rates in office-based dermatologic surgery using large flap, large graft, and interpolation flap repairs. The authors evaluated the relationship between these complications and surgical site, closure type, repair size, antibiotic use, and antithrombotic use.
Eligible patients were identified through searching the electronic medical records from one Mohs micrographic surgeon at University Hospitals Medical Center. Patient information, surgery characteristics, and complication information were collected. Univariate and multivariate analyses were conducted to reveal associations between each complication and closure type, repair size, repair site, antithrombotic use, and antibiotic use.
Three hundred and thirty-one reconstruction procedures after Mohs micrographic surgery and excision qualified for the study. The rates of postoperative infection, hemorrhage, hematoma, necrosis, and dehiscence were 5%, 0.3%, 2.4%, 3%, and 0.9%, respectively.
Complications were infrequent and non-life-threatening. The authors' results indicate that dermatologic surgery using large flaps, interpolation flaps, and large grafts is safe in the office setting.
随着皮肤外科手术数量持续增加，评估门诊环境下皮肤科手术的安全性很重要。
作者试图确定在门诊进行的皮肤科手术中，采用大皮瓣、大皮片和插入皮瓣修复术后的出血、感染、裂开和坏死率。作者评估了这些并发症与手术部位、闭合类型、修复大小、抗生素使用和抗血栓药物使用之间的关系。
通过检索大学医院医疗中心一名莫氏显微外科医生的电子病历确定符合条件的患者。收集患者信息、手术特征和并发症信息。进行单因素和多因素分析以揭示每种并发症与闭合类型、修复大小、修复部位、抗血栓药物使用和抗生素使用之间的关联。
331例莫氏显微外科手术和切除术后的重建手术符合研究条件。术后感染、出血、血肿、坏死和裂开的发生率分别为5%、0.3%、2.4%、3%和0.9%。
并发症发生率低且不危及生命。作者的结果表明，在门诊环境下使用大皮瓣、插入皮瓣和大皮片进行皮肤科手术是安全的。
