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Abbott RA, Cordaro A, Lloyd B, Cannings-John R, Wootton M, Kirby N, Pickles T, McQueen A, Westmoreland M, Ziaj S, Martin-Clavijo A, Wernham A, Matin R, Thomas-Jones E. Observational study to estimate the proportion of surgical site infection following excision of ulcerated skin tumours (OASIS study). Clin Exp Dermatol 2022; 47:882-888. [PMID: 34855996 DOI: 10.1111/ced.15037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 12/01/2022]
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.
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Affiliation(s)
- R A Abbott
- Department of Dermatology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
| | - A Cordaro
- Department of Dermatology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
| | - B Lloyd
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - M Wootton
- Specialist Antimicrobial Chemotherapy Unit, Public Health Wales, Cardiff, UK
| | - N Kirby
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - T Pickles
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - A McQueen
- Department of Dermatology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK
| | - M Westmoreland
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Ziaj
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A Martin-Clavijo
- Department of Dermatology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Wernham
- Department of Dermatology, Manor Hospital, Walsall Healthcare NHS Trust, Wallsall, UK
- Department of Dermatology, Leicester Royal Infirmary, Leicester University Hospitals NHS Trust, Leicester, UK
| | - R Matin
- Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - E Thomas-Jones
- Centre for Trials Research, Cardiff University, Cardiff, UK
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Lonsdale DO, Lipman J. Global personalization of antibiotic therapy in critically ill patients. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2021. [DOI: 10.1080/23808993.2021.1874823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Dagan O Lonsdale
- Department of Clinical Pharmacology, St George’s, University of London, London, UK
- Department of Critical Care, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Jeffrey Lipman
- Department of Intensive Care, Royal Brisbane and Women’s Hospital, Brisbane, Australia
- University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia
- Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France
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