Patient‐dependent risk factors for wound infection after skin surgery: A systematic review and meta‐analysis

Abstract

Postoperative wound infection in dermatologic surgery causes impaired wound healing, poor cosmetic outcome and increased morbidity. Patients with a highrisk profile may benefit from perioperative antibiotic prophylaxis. The objective of this systematic review was to identify risk factors for surgical site infection after dermatologic surgery. In this article, we report findings on patientdependent risk factors. The literature search included MEDLINE, EMBASE, CENTRAL and trial registers. We performed meta-analysis, if studies reported sufficient data to calculate risk ratios with 95% confidence intervals. Study quality was assessed according to the Newcastle-Ottawa-Scale. Seventeen observational studies that analysed 31213 surgical wounds were eligible for inclusion. Fourteen studies qualified for meta-analysis. Nine studies showed good, three fair and five poor methodological quality. The reported incidence of surgical site infection ranged from 0.96% to 8.70%. Meta-analysis yielded that male gender and immunosuppression were significantly associated with higher infection rates. There was a tendency towards a higher infection risk for patients with diabetes, without statistical significance. Meta-analysis did not show different infection rates after excision of squamous cell carcinoma or basal cell carcinoma, but studies were substantially heterogenous. There was no significant association between risk for wound infection and smoking, age over 60 years, oral anti-aggregation or anti-coagulation or excision of malignant melanoma. In conclusion, the risk for surgical site infection in dermatologic surgery is low. Infection rates were increased significantly in male as well as immunosuppressed patients and non-significantly in diabetics.

Bacteriology of Wound Infections in Nigeria and its Effect on Antimicrobials Selection during Management

“…According to this study, age, gender, and wound type were not significant risk factors for wound infection [48]. On the contrary, a meta-analysis of postoperative wound infections returned that male gender and immunosuppression were significantly associated with higher infection rates in patients [49].…”

Trends of research on antibiotic prophylaxis and surgical site infection: A bibliometric review based on VOS viewer by Scopus database

“…Cluster 4 describes the subject of research on prophylactic antibiotics and surgical site infections. Patients with a higher age have a greater risk of playing a role in the incidence of surgical site infection [24]. A study states that there is a relationship between gender and the incidence of surgical site infection in gastric cancer surgery [25].…”

Perioperative Antibiotikaprophylaxe in der Dermatochirurgie – Positionspapier der Arbeitsgruppe Antibiotic Stewardship der Deutschen Gesellschaft für Dermatochirurgie (DGDC), Teil 1: Eingriffs‐ und patientenbezogene Risikofaktoren

“…35 Eine rezente Metaanalyse fand hingegen, dass Immunsuppression mit einem signifikant erhöhten Risiko für Wundinfektionen verbunden war (RR 2,11; 95% KI 1,02-4,39). 36 Dies ergab auch eine große prospektive Beobachtungsstudie mit 3491 Patienten (OR 9,99; 95% KI 1,83-54,3). 37 Zudem zeigte eine retrospektive Kohorte, dass Immunsuppression im Rahmen der Ohrrekonstruktion einen Risikofaktor für das Auftreten einer SSI darstellt.…”

“…In einer Metaanalyse mit neun Beobachtungsstudien konnte gezeigt werden, dass Männer ein höheres Wundinfektionsrisiko nach dermatochirurgischen Eingriffen haben als Frauen (RR 1.51; 95% KI 1,24-1,85). 36 Auch eine große prospektive Studie mit 3491 Patienten fand ein erhöhtes Wundinfektionsrisiko bei männlichen Patienten (OR 5.46; 95% KI 1.12-26.54). 37 In einer kleineren retrospektiven Studie mit 512 Patienten fand sich hingegen kein signifikanter Unterschied in der Infektionsrate zwischen beiden Geschlechtern.…”