ABSTRACT
BACKGROUND: Ulceration is a recognized risk factor for surgical site infection (SSI); however, the proportion of patients developing SSI after excision of an ulcerated skin cancer is unknown. AIM: To determine the proportion of participants with SSI after surgical excision of an ulcerated skin cancer. A secondary aim was to assess feasibility outcomes to inform the design of a randomized controlled trial to investigate the benefits and harms of perioperative antibiotics following excision of ulcerated tumours. METHODS: This was a multicentre, prospective, observational study of patients undergoing excision of an ulcerated skin cancer between March 2019 and March 2020. Prior to surgical excision, surface swabs of the ulcerated tumours of participants recruited from one centre were undertaken to determine organism growth. At 4 weeks after surgery, all participants were e-mailed or posted the Wound Healing Questionnaire (WHQ) to determine whether they had developed SSI. RESULTS: In total, 148 participants were recruited 105 (70.9%) males; mean ± SD age 77.1 ± 12.3 years. Primary outcome data were available for 116 (78.4%) participants, of whom 35 (30.2%) were identified as having an SSI using the WHQ with a cutoff score of 8, and 47 (40.5%) were identified with a cutoff score of 6. Using the modified WHQ in participants with wounds left to heal by secondary intention, 33 (28.4%) and 43 (37.1%) were identified to have SSI respectively. CONCLUSION: This prospective evaluation of SSI identified with the WHQ following excision of ulcerated skin cancers demonstrated a high proportion with SSI. The WHQ was acceptable to patients; however, further evaluation is required to ensure validity in assessing skin wounds.
Subject(s)
Skin Neoplasms , Surgical Wound Infection , Aged , Aged, 80 and over , Anti-Bacterial Agents , Female , Humans , Male , Middle Aged , Skin Neoplasms/surgery , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Wound HealingABSTRACT
The value of Ga-67 scanning to detect acute infectious lung disease has been described. We present a patient who apparently improved both clinically and radiographically after acute Legionnaires' pneumonia. Five months later a relapse developed. During his relapse the pulmonary uptake of Ga-67 and the appearance of chest x-rays were disparate. We suggest that pulmonary Ga-67 uptake may be a more sensitive indicator of the resolution of pneumonia than is chest radiography. Therapeutic success may be assumed when pulmonary Ga-67 uptake is absent.
