Niklinska Eva B, Hicks Alexander, Wheless Lee, Hanlon Allison
Vanderbilt University School of Medicine, Eskind Family Biomedical Library and Learning Center, Nashville, Tennessee.
Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee.
Dermatol Surg. 2021 Dec 1;47(12):1547-1550. doi: 10.1097/DSS.0000000000003260.
Surgical site infection (SSI) is the most common complication for Mohs micrographic surgery (MMS). Lower extremity surgical sites are at an increased risk for developing SSI.
This study aimed to evaluate lower extremity SSI rates post-MMS based on closure type and antibiotic usage.
A retrospective review was performed of all lower extremity MMS cases from 2011 to 2016 at Vanderbilt University Medical Center. Patient history, surgical details, and follow-up appointments were reviewed.
Six hundred twenty MMS lower extremity surgeries were eligible. Review identified an overall lower extremity SSI rate of 7.4%. Infection rates were significantly increased in wound closed by flaps/grafts (p < .001). Although wound size and preoperative antibiotic prophylaxis were initially associated with increased infection rate (p = .03, p = .015), the associations were fully attenuated when adjusting for closure type.
More complicated repair techniques (flap/graft) for larger wound sizes contribute to increased SSI risk among lower extremity MMS cases. Providers can use this information to guide antibiotic prophylaxis.
手术部位感染（SSI）是莫氏显微外科手术（MMS）最常见的并发症。下肢手术部位发生SSI的风险增加。
本研究旨在根据闭合类型和抗生素使用情况评估MMS术后下肢SSI发生率。
对范德比尔特大学医学中心2011年至2016年所有下肢MMS病例进行回顾性研究。回顾患者病史、手术细节和随访情况。
620例下肢MMS手术符合条件。研究发现下肢SSI总发生率为7.4%。皮瓣/移植片闭合的伤口感染率显著升高（p <.001）。虽然伤口大小和术前抗生素预防最初与感染率增加相关（p = 0.03，p = 0.015），但在调整闭合类型后，这种相关性完全减弱。
对于较大伤口采用更复杂的修复技术（皮瓣/移植片）会增加下肢MMS病例的SSI风险。医疗人员可利用这些信息指导抗生素预防。
