Postoperative Infections in Dermatologic Surgery: The Role of Wound Cultures

Kimberly M. Ken, Mariah M. Johnson, Justin J. Leitenberger, Donald E. Neal, Jeremy R. Etzkorn, Panayiota Govas, Bryan T. Carroll, Ahmed H. Badawi, Tejaswi Mudigonda, M. Laurin Council, Christina Avila, David R. Carr, Jodie Sasaki, Travis W. Blalock, Nicholas J. Golda

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

BACKGROUND: Dermatologic surgery is associated with low postoperative infection rates, averaging from approximately 1% to 4.25%. Often, postoperative infections are treated empirically based on clinical diagnosis of infection, given it can take 48 to 72 hours for a wound culture to identify a pathogen. OBJECTIVE: We aimed to evaluate the efficacy of empiric antibiotics in dermatologic surgery postoperative infections and if wound cultures change postoperative antibiotic therapy. METHODS: A 7-center, retrospective analysis of postoperative infections, with culture data, in dermatologic surgery patients was performed. RESULTS: Of 91 cases of clinically diagnosed postoperative infection, 82.4% (n = 75) were successfully treated with empiric oral antibiotics (95% confidence interval [0.73-0.89], p < .0001). In 16 (17.6%) cases, initial empiric antibiotics were unsuccessful, and wound culture results altered antibiotic therapy in 9 cases (9.9%) with 6 (6.6%) of these cases requiring additional coverage for methicillin-resistant Staphylococcus aureus (MRSA). CONCLUSION: Empiric antibiotic treatment is usually appropriate for patients with postoperative surgical-site infections with wound cultures altering antibiotic management in a minority of cases. When empiric antibiotics fail, lack of MRSA coverage is usually the cause; therefore, providers should be aware of local MRSA prevalence and susceptibilities.

Original languageEnglish (US)
Pages (from-to)1294-1299
Number of pages6
JournalDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
Volume46
Issue number10
DOIs
StatePublished - Oct 1 2020

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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