ABSTRACT
BACKGROUND: Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS: All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS: The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION: According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients.
Subject(s)
Dermatologic Surgical Procedures/adverse effects , Immunocompromised Host , Immunosuppression Therapy/adverse effects , Skin Neoplasms/surgery , Surgical Wound Infection/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Keratosis, Actinic/surgery , Length of Stay , Male , Middle Aged , Retrospective Studies , Risk Factors , Surgical Wound Infection/drug therapy , Young AdultSubject(s)
Anodontia/genetics , Eccrine Glands/abnormalities , Eyelid Neoplasms/genetics , Hypotrichosis/genetics , Keratoderma, Palmoplantar/genetics , Mutation, Missense/genetics , Wnt Proteins/genetics , Anodontia/diagnosis , Anodontia/surgery , Apocrine Glands/surgery , Diagnosis, Differential , Eccrine Glands/surgery , Eyelid Neoplasms/diagnosis , Eyelid Neoplasms/surgery , Female , Heterozygote , Hidrocystoma/diagnosis , Hidrocystoma/genetics , Hidrocystoma/surgery , Humans , Hypotrichosis/diagnosis , Hypotrichosis/surgery , Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/surgery , Middle Aged , Phenotype , Sweat Gland Neoplasms/diagnosis , Sweat Gland Neoplasms/genetics , Sweat Gland Neoplasms/surgeryABSTRACT
BACKGROUND: Bioelectrical impedance spectroscopy is applied to measure changes in tissue composition. The aim of this study was to evaluate its feasibility in measuring the fluid shift after thoracentesis in patients with pleural effusion. METHODS: 45 participants (21 with pleural effusion and 24 healthy subjects) were included. Bioelectrical impedance was analyzed for "Transthoracic," "Foot to Foot," "Foot to Hand," and "Hand to Hand" vectors in low and high frequency domain before and after thoracentesis. Healthy subjects were measured at a single time point. RESULTS: The mean volume of removed pleural effusion was 1169 ± 513 mL. The "Foot to Foot," "Hand to Hand," and "Foot to Hand" vector indicated a trend for increased bioelectrical impedance after thoracentesis. Values for the low frequency domain in the "Transthoracic" vector increased significantly (P < 0.001). A moderate correlation was observed between the amount of removed fluid and impedance change in the low frequency domain using the "Foot to Hand" vector (r = -0.7). CONCLUSION: Bioelectrical impedance changes in correlation with the thoracic fluid level. It was feasible to monitor significant fluid shifts and loss after thoracentesis in the "Transthoracic" vector by means of bioelectrical impedance spectroscopy. The trial is registered with Registration Numbers IRB EK206/11 and NCT01778270.
