The need for antibiotic prophylaxis in predominant infections after conventional dermatologic surgeries
Keywords:
dermatologic surgery, surgical wound infection, antibiotic prophylaxis.Abstract
Introduction: Healthcare-associated infections are frequent in the healthcare environment, especially in hospitals. Public health concern is significate, both because of their high morbidity and mortality and their economic cost.
Objective: To analyze the need for antibiotic prophylaxis in patients undergoing conventional dermatologic surgery.
Methods: An observational, descriptive and longitudinal study was conducted to identify the presence of surgical site infection in 50 patients operated on by conventional surgery in the dermatology service of Hermanos Ameijeiras Clinical-Surgical Hospital in the period from May 1, 2019 to May 31, 2021.
Results: Of the 50 patients, five (10%) presented surgical site infection. Staphylococcus aureus was the most frequent microorganism isolated in the study patients (6.0%). 57.8% of patients without surgical site infection did not receive antibiotic prophylaxis.
Conclusions: 57.8% of patients without surgical site infection did not receive antibiotic prophylaxis, a reason why the surgical site infection would seem to be more associated to other risk factors, which leaves prophylaxis as an issue to be analyzed individually for each patient.
Downloads
References
Soriano Viladomiu A, del Río Bueno A, Trilla García A. Infecciones relacionadas con la asistencia sanitaria: medidas de prevención y control. En: Farreras Rozman. Medicina Interna. 19na. Ed. Elsevier: España, 2020. pp. 2419-27.
Berríos Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Healthcare infection control practices advisory committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection. JAMA Surg. 2017 [acceso: 05/05/2021];152(8):784-91. Disponible en: https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725
Todd B. New CDC Guideline for the Prevention of Surgical Site Infection. Am J Nurs. 2017 [acceso: 05/05/2021];117(8):17. Disponible en: https://journals.lww.com/ajnonline/Fulltext/2017/08000/New_CDC_Guideline_for_the_Prevention_of_Surgical.16.aspx
Solomkin JS, Mazuski J, Blanchard JC, Itani KMF, Ricks P, Dellinger EP, et al. Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections. Surg Infect (Larchmt). 2017 [acceso: 05/05/2021];18(4):385-93. Disponible en: https://www.liebertpub.com/doi/abs/10.1089/sur.2017.075?journalCode=sur
Centers for Disease Control/ National Nosocomial Infections Surveillance. Surveillance Definitions for Specific Types of Infections. CDC. 2021 [acceso: 05/05/2021]. Disponible en: http://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf
National Nosocomial Infections Surveillance. System Report, data summary. Am J Infect Control. 2004 [acceso: 05/05/2021];32(8):470-85. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0196655304005425
Baxter Campaña MM, Frómeta Suárez I. Vigilancia de las infecciones asociadas a la asistencia sanitaria. Rev Cubana Med. 2016 [acceso: 05/05/2021];55(3):190-201. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232016000300002&lng=es.
Centers for Disease Control/National Nosocomial Infections Surveillance. Procedure-associated Module. Surgical Site Infection (SSI) Event. CDC. 2018 [acceso: 05/05/2021]. Disponible en: http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf
Dietert JB, Ko J, Hurst EA. Positive bacterial culture results at a dermatologic surgery center: A single-site retrospective review. Dermatol Surg. 2020 [acceso: 05/05/2021];46(6):773-9. Disponible en: https://insights.ovid.com/pubmed?pmid=31592927
Ken KM, Johnson MM, Leitenberger JJ, Neal DE, Etzkorn JR, Govas P, et al. Postoperative infections in dermatologic surgery: The role of wound cultures. Dermatol Surg. 2020 [acceso: 05/05/2021];46(10):1294-9. Disponible en: https://journals.lww.com/dermatologicsurgery/Abstract/2020/10000/Postoperative_Infections_in_Dermatologic_Surgery_.5.aspx
European Centre for Disease Prevention and Control. Surveillance of surgical site infections and prevention indicators in European hospitals-HAI-Net SSI protocol, version 2.2. Stockholm: ECDC; 2017.
Liu X, Sprengers M, Nelemans PJ, Mosterd K, Kelleners-Smeets NWJ. Risk factors for surgical site infections in dermatological surgery. Acta Derm Venereol. 2018 [acceso: 05/05/2021];98(2):246-50. Disponible en: https://www.medicaljournals.se/acta/content/html/10.2340/00015555-2844
Valdés Madrigal I, Vega Naranjo AM, Elías Montes Y, Sánchez Hidalgo Md, Borges Sánchez E. Algunos factores de riesgo asociados a infecciones del sitio quirúrgico en niños. RM. 2018 [acceso: 05/05/2021];22(6):[aprox. 15 p.]. Disponible en: http://www.revmultimed.sld.cu/index.php/mtm/article/view/1033
Ranario JS, Watkins BF, Shimizu I. Rate of surgical site infections with new rotocol of rophylactic antibiotic use in dermatologic surgery. Dermatol Surg. 2018 [acceso: 05/05/2021];44(2):304-6. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/28498209
Hernández Cantú EI, Esparza Dávila SP, Reyes Silva AK. Eficacia de un modelo de prevención de infección de sitio quirúrgico en un hospital de segundo nivel de atención. Index Enferm. 2020 [acceso: 05/05/2021];29(1-2):9-12. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1132-12962020000100003&lng=es
Excellence NifHaC. NICE guideline: prevention and treatment of surgical site infection. London; 2017. [acceso: 05/05/2021]. Disponible en: https://www.nice.org.uk/guidance/cg74.
Healthcare Infection Control Practices Advisory Committee Centers for Disease Control and Prevention. The Guideline for the Prevention of Surgical Site Infection. Atlanta: HICPAC; 2017.
Todd B. New CDC Guideline for the Prevention of Surgical Site Infection. Am J Nurs. 2017 [acceso: 05/05/2021];117(8):17. Disponible en: https://journals.lww.com/ajnonline/Fulltext/2017/08000/New_CDC_Guideline_for_the_Prevention_of_Surgical.16.aspx
Solomkin JS, Mazuski J, Blanchard JC, Itani KMF, Ricks P, Dellinger EP, et al. Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections. Surg Infect (Larchmt). 2017 [acceso: 05/05/2021];18(4):385-93. Disponible en: https://www.liebertpub.com/doi/abs/10.1089/sur.2017.075?journalCode=sur
Strickler AG, Shah P, Bajaj S, Mizuguchi R, Nijhawan RI, Odueyungbo M, et al. Preventing complications in dermatologic surgery: Presurgical concerns. J Am Acad Dermatol. 2021 [acceso: 05/05/2021];84(4):883-92. Disponible en: https://www.jaad.org/article/S0190-9622(21)00186-9/fulltext
Hart D, Postlethwait RW, Brown IW Jr, Smith WW, Johnson PA. Postoperative wound infections: a further report on ultraviolet irradiation with comments on the recent (1964) national research council cooperative study report. Ann Surg. 1968 [acceso: 05/05/2021];167(5):728-43. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1387124/
Maragh SL, Otley CC, Roenigk RK, Phillips PK. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg. 2005 [acceso: 05/05/2021];31:83-91. Disponible en: https://journals.lww.com/dermatologicsurgery/pages/articleviewer.aspx?year=2005&issue=01000&article=00015&type=abstract
Liu X, Kelleners Smeets NWJ, Sprengers M, Hira V, Mosterd K, Nelemans PJ. A Clinical prediction model for surgical site infections in dermatological surgery. Acta Derm Venereol. 2018 [acceso: 05/05/2021];98(7):683-8. Disponible en: https://www.medicaljournals.se/acta/content/abstract/10.2340/00015555-2945
Futoryan T, Grande D. Postoperative wound infection rates in dermatologic surgery. Dermatol Surg. 1995 [acceso: 05/05/2021];21:509-14. Disponible en: https://journals.lww.com/dermatologicsurgery/Abstract/1995/06000/Postoperative_Wound_Infection_Rates_in.6.aspx
Friedman ND, Kaye KS, Stout JE, McGarry SA, Trivette SL, Briggs JP, et al. Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med. 2002 [acceso: 05/05/2021];137(10):791-7. Disponible en: https://www.acpjournals.org/doi/10.7326/0003-4819-137-10-200211190-00007
Smack DP, Harrington AC, Dunn C, Howard RS, Szkutnik AJ, Krivda SJ, et al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs. bacitracin ointment. A randomized controlled trial. JAMA. 1996 [acceso: 05/05/2021];276:972-7. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/vol/276/pg/972
Griego RD, Zitelli JA. Intraincisional prophylactic antibiotics for dermatologic surgery. Arch Dermatol. 1998 [acceso: 05/05/2021];134:688-92. Disponible en: https://jamanetwork.com/journals/jamadermatology/fullarticle/vol/134/pg/688
Smith H, Borchard K, Cherian P, Vinciullo C. Multivariate logistic regression of risk factors for surgical site infection following Mohs surgery. Australas J Dermatol. 2020 [acceso: 05/05/2021];61(3):288-9. Disponible en: https://onlinelibrary.wiley.com/doi/10.1111/ajd.13251
Balakirski G, Kotliar K, Pauly KJ, Krings LK, Rübben A, Baron JM, et al. Surgical site infections after dermatologic surgery in immunocompromised patients: A Single-Center Experience. Dermatol Surg. 2018 [acceso: 05/05/2021];44(12):1525-36. Disponible en: https://journals.lww.com/dermatologicsurgery/Abstract/2018/12000/Surgical_Site_Infections_After_Dermatologic.7.aspx
Smith C, Srivastava D, Nijhawan RI. Optimizing Patient Safety in Dermatologic Surgery. Dermatol Clin. 2019 [acceso: 05/05/2021];37(3):319-28. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0733863519300178?via%3Dihub
Nguyen JK, Huang A, Siegel DM, Jagdeo J. Variability in wound care recommendations following dermatologic procedures. Dermatol Surg. 2020 [acceso: 05/05/2021];46(2):186-91. Disponible en: https://journals.lww.com/dermatologicsurgery/Abstract/2020/02000/Variability_in_Wound_Care_Recommendations.6.aspx
Balakirski G, Felcht M, Bayer H, Schmitt L. Analysis of the status quo of perioperative antibiotic prophylaxis in dermatosurgery in Germany: results of the DESSI-study. J Dtsch Dermatol Ges. 2019 [acceso: 05/05/2021];17(7):703-13. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/ddg.13864
Bencini PL, Galimerti M, Signorini M. Utility of topical benzoil peroxide for prevention of surgical skin wound infection. J Dermatol Surg Oncol 1994 [acceso: 05/05/2021];20:538-40. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8056888/
Nieto Benito LM, Vilas Boas P, Zaballos M, Llorente Parrado C, Avilés Izquierdo JA. Recomendaciones en la petición de pruebas preoperatorias en cirugía dermatológica ambulatoria. Actas Dermo Sifiliograf. 2019 [acceso: 05/05/2021];110(6):469-73. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0001731019301188
Liu X, Sprengers M, Nelemans PJ, Mosterd K, Kelleners Smeets NWJ. Risk factors for surgical site infections in dermatological surgery. Acta Derm Venereol. 2018 [acceso: 05/05/2021];98(2):246-50. Disponible en: https://www.medicaljournals.se/acta/content/abstract/10.2340/00015555-2844
Baran CN, Sensoz O, Ulusoy MG. Prophylactic antibiotics in plastic and reconstructive surgery. Plast Reconstr Surg 1999 [acceso: 05/05/2021];103(12):1561-6. Disponible en: https://insights.ovid.com/pubmed?pmid=10323688
Duarte Linares Y, Portal Benítez LN, Rodríguez Rojas DA, Zurbano Fernández J. Caracterización de pacientes con infección del sitio quirúrgico. Acta Med Centro. 2021 [acceso: 05/05/2021];15(3):[aprox. 0 p.]. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/1406
Romero Ramírez HA. Relación entre el cumplimiento de normas de bioseguridad e incidencia de infección de la herida quirúrgica. Departamento de Cirugía, Hospital del Seguro Social de Babahoyo, Ecuador, 2015 [Tesis de doctorado]. Lima: Universidad Nacional Mayor de San Marcos; 2017 [acceso: 05/05/2021]. Disponible en: http://cybertesis.unmsm.edu.pe/xmlui/bitstream/handle/cybertesis/6314/Romero_rh.pdf
López Jiménez SL, Jácome Álvarez MK. Infección de heridas quirúrgicas en pacientes adultos [Tesis de grado]. Guayaquil: Universidad de Guayaquil; 2018 [acceso: 05/05/2021]. Disponible en: http://repositorio.ug.edu.ec/bitstream/redug/31029/1/CD-2425-TESIS-LOPEZ%20JIMENEZ.pdf
Vásquez Peralta MH, Comboza Morales RE, Vargas León IV, Gallegos Valverde MG, Peña Murillo EL, Simancas Racines AC. Diagnóstico microbiológico. Su importancia en las infecciones quirúrgicas. Rev Cubana Reumatol. 2018 [acceso: 05/05/2021];20(3):61-72. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1817-59962018000300009
Vásquez Peralta MH. ¿Qué nos dicen los estudios de incidencia de infección de la herida quirúrgica? Enfermería Investiga. 2019 [acceso: 05/05/2021];3(1):15-22. Disponible en: https://revistas.uta.edu.ec/erevista/index.php/enfi/article/view/419
Juárez Dobjanschi MC, Bassas Freixas P, Ferrándiz Pulido C, Bodet Castillo D, Hilari Carbonell H, Mollet Sánchez J, et al. Factores de riesgo relacionados con la infección de la herida quirúrgica en cirugía dermatológica. Estudio prospectivo en un hospital de tercer nivel. Piel. 2021 [acceso: 05/05/2021];18(3):28-44. Disponible en: https://www.sciencedirect.com/science/article/pii/S0213925120304007
Ganguli S. Exploring a new trend in the use of antibiotics in dermatologic procedures. Am J Infect Control. 2019 [acceso: 05/05/2021];47(11):1403. Disponible en: https://www.ajicjournal.org/article/S0196-6553(19)30234-2/fulltext
Fathy R, Chu B, James WD, Barbieri JS. The frequency of topical antibiotic use after biopsy and excision procedures among dermatologists and nondermatologists: 2006 through 2015. J Am Acad Dermatol. 2020 [acceso: 05/05/2021];82(5):1258-61. Disponible en: https://www.jaad.org/article/S0190-9622(20)30036-0/fulltext
García Ferrero E, Muñoz Pinilla J, Jiménez Rodriguez E, Madrid U. Factores de riesgo en la infección de la herida quirúrgica y su prevención. CEECir Digital. 2018 [acceso: 05/05/2021];10(4):4. Disponible en: http://www.seecir.es/images/Revista_SEECir_Digital/SEECir_Digital_Vol10.pdf#page=4
Harlan CA, Nguyen NB, Hirshburg JM, Hirshburg JM. Updates on Recommendations for prophylactic antibiotics in dermatologic surgery. Dermatol Surg. 2021 [acceso: 05/05/2021];47(2):298-300. https://journals.lww.com/dermatologicsurgery/Citation/2021/02000/Updates_on_Recommendations_for_Prophylactic.49.aspx
Johnson Jahangir H, Agrawal N. Perioperative antibiotic use in cutaneous surgery. Dermatol Clin. 2019 [acceso: 05/05/2021];37(3):329-40. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0733863519300221
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
