Flaps or grafts increase surgical site infection risk among lower extremity MMS cases: Study

This study aimed to evaluate lower extremity SSI rates post-MMS based on closure type and antibiotic usage. A retrospective review was performed of all lower extremity MMS cases from 2011 to 2016 at Vanderbilt University Medical Center. Patient history, surgical details, and follow-up appointments were reviewed.

The Results of the study are as follows:

Six hundred twenty MMS lower extremity surgeries were eligible. The review identified an overall lower extremity SSI rate of 7.4%. Infection rates were significantly increased in wounds closed by flaps/grafts (p < .001). Although wound size and preoperative antibiotic prophylaxis were initially associated with increased infection rate (p = .03, p = .015), the associations were fully attenuated when adjusting for closure type.

Thus, the researchers concluded that more complicated repair techniques (flap/graft) for larger wound sizes contribute to increased SSI risk among lower extremity MMS cases. Providers can use this information to guide antibiotic prophylaxis.

Reference:

Characteristics of Lower Extremity Infection Rates Following Mohs Micrographic Surgery by Niklinska, Eva et al. published in the Dermatologic Surgery.

https://journals.lww.com/dermatologicsurgery/fulltext/2021/12000/characteristics_of_lower_extremity_infection_rates.3.aspx