Background:
Local anaesthetic skin surgery is a cornerstone of the service offered in all NZ PRS units.. Surgical site infections in skin surgery affect patient recovery, increase demand on hospital resources and may require unplanned readmission. Rates vary but between 2-10% is quoted within the worldwide literature 1
Traditionally, worldwide data suggests more complex procedures such as grafts of local flaps conveys an increased risk of infection, although this is most commonly seen in an outpatient dermatological setting
We audited 12 months of patients to determine the risk factors for SSI
Methods
Patient electronic records were retrospectively assessed from April 2023 – April 2024
Hospital codes for those procedures were searched for
Demographic data was collected
Infection was defined as the presence of clinical signs of infection on review and positive wound cultures
Simple statistical analysis was performed on the data collected to determine risk factors associated with infection in our population
Results:
556 patients had a Flap/SSG
Mean age 73
60:40 M:F
140 Flaps, 416 Graft
Surgical sites 50% Head/Neck, 30% Lower Limb, 15% Upper limb, 5% Upper limb
56 Patients had an identified SSI
38 graft infections, 18 flap infections
Identified risk factors were lower limb graft, ear graft, smoking, diabetes, age >75
Discussion
We were able to demonstrate that SSI in the Hutt population is at 10% for the 12 months period sampled in this study.
Our small sample size in comparison to larger studies may affect data, but this could be borne out by sampling a longer time period.
Risk factors identified generally followed those seen in worldwide data
Future prospects would be to determine a risk stratification system to determine safe prophylactic antibiotic use.
1 Schlager, et al. 2023, Surgical Site Infection in Skin Surgery – an observational study, International Wound Journal, November 20 (9)