Hicks Alexander, Mazumder Anika, Moody Rylee, Kumanan Krithika, Behshad Ramona
Skin and Allergy Center, Spring Hill, TN.
Cook County Health, Department of Dermatology, Chicago, IL.
Dermatol Surg. 2023 Nov 1;49(11):981-984. doi: 10.1097/DSS.0000000000003915. Epub 2023 Sep 18.
Surgical site infections (SSIs) are the most common adverse events after Mohs micrographic surgery (MMS). However, there is a paucity of literature characterizing gram-negative (GN) SSIs after MMS.
This study aimed to depict the clinical features and risk factors of GN infections after MMS.
A retrospective review was performed from all postoperative wound cultures after MMS from 2017 to 2021 at Saint Louis University Medical Center. Patient demographics, surgical details, and wound clinical characteristics at follow-up appointments were reviewed.
Six hundred and seventy-six wound cultures were eligible with 15.1% yielding GN infection. Gram-negative SSIs had significantly lower rates of severe erythema and purulence compared with gram-positive (GP) SSIs, and only had significantly more edema compared with culture-negative wounds ( p < .05). Although not significant, there was a trend for GN SSIs to have higher rates of pain compared with culture-negative wounds ( p = .075).
Gram-negative SSIs after MMS may present with more subtle clinical features, especially compared with typical GP infections. Having a low threshold for obtaining wound culture for edematous or painful postoperative wounds may aid in detecting potentially overlooked GN infections.
手术部位感染（SSIs）是莫氏显微外科手术（MMS）后最常见的不良事件。然而，关于MMS后革兰氏阴性（GN）SSIs的文献较少。
本研究旨在描述MMS后GN感染的临床特征和危险因素。
对圣路易斯大学医学中心2017年至2021年MMS术后所有伤口培养物进行回顾性分析。回顾患者的人口统计学资料、手术细节以及随访时伤口的临床特征。
676份伤口培养物符合条件，15.1%培养出GN感染。与革兰氏阳性（GP）SSIs相比，革兰氏阴性SSIs的严重红斑和化脓发生率显著更低，与培养阴性伤口相比，仅水肿发生率显著更高（p < 0.05）。尽管差异不显著，但与培养阴性伤口相比，GN SSIs的疼痛发生率有更高的趋势（p = 0.075）。
MMS后的革兰氏阴性SSIs可能表现出更隐匿的临床特征，尤其是与典型的GP感染相比。对于术后水肿或疼痛的伤口，降低获取伤口培养物的阈值可能有助于检测潜在被忽视的GN感染。
