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- Title
Surgical‐site infections after full‐thickness skin grafting.
- Authors
Palmgren, J.; Paoli, J.; Schmidtchen, A.; Saleh, K.
- Abstract
Summary: The authors of this paper from Sweden note that there are more than 30 definitions of surgical site infection (SSI, or post‐operative infection), and that even the most widely used is open to interpretation. To look at consistency in diagnosing SSI, they sent eight standardised photographs to dermatologists around the world. Each photograph showed a patient one week after a skin graft on the face, and in each case the dermatologists were asked if they thought the wound looked infected. (The investigators first assessed the photographs themselves, using a scoring system to explain why an SSI might be suspected.) At the time of photography, no patient had pain, heat, or pus coming from the wound. All wounds were also assessed in person by the same investigator and swabbed to see if bacteria could be grown. There were 393 responses from 27 countries. The degree of agreement as to whether the photographs showed an SSI was only slight. Three wounds were interpreted as infected by 70%, 65% and 33% of responders, respectively, and these were the same three that were assessed as infected by the investigator in person. Fewer than 25% of responders thought the other five wounds were infected. The feature that made most responders diagnose infection was redness. The dermatologist responders were also asked how they would manage an SSI. Topical antibiotics were favoured by 14%, even though evidence for effectiveness is lacking. The authors conclude that diagnosing SSI is difficult using current guidance, at least when examining photographs. Linked Article: Palmgren et al. Br J Dermatol 2019; 180:1169–1175
- Subjects
SWEDEN; SKIN grafting; SURGICAL site infections; INFECTION
- Publication
British Journal of Dermatology, 2019, Vol 180, Issue 5, pe161
- ISSN
0007-0963
- Publication type
Article
- DOI
10.1111/bjd.17800