Wahie S, Lawrence CM, et al.
Archives of dermatology. Date of publication 2007 Oct 1;volume 143(10):1267-71.
1. Arch Dermatol. 2007 Oct;143(10):1267-71.
Wound complications following diagnostic skin biopsies in dermatology inpatients.
Wahie S(1), Lawrence CM.
Author information:
(1)Department of Dermatology, Royal Victoria Infirmary, Queen Victoria Road,
Newcastle upon Tyne NE1 4LP, England. shyamalwahie@hotmail.com
OBJECTIVES: To prospectively determine the wound complication rate for
dermatology inpatients undergoing diagnostic skin biopsies during their admission
and to determine significant host and procedural risk factors.
DESIGN: Prospective assessment, by a single observer, of 100 postdiagnostic skin
biopsy wounds in dermatology inpatients. The following data were recorded for
each patient: age and sex, presence of comorbidities, smoking status,
dermatologic diagnosis, use of immunosuppressive or antibiotic therapy, place of
biopsy (whether in the operation theater or in the ward), grade of physician
performing biopsy, biopsy site on the body, type of biopsy (whether elliptical
incision, punch, shave, or curettage), and wound closure technique.
MAIN OUTCOME MEASURE: Wounds were designated as having had no complication or as
being complicated by infection, dehiscence, and/or hematoma.
SETTING: A dedicated dermatology inpatient ward in a university teaching
hospital.
RESULTS: Wound complications occurred in 29 (29%) biopsies, 27 (93%) of which
were the result of wound infection. Complications occurred significantly more
frequently when biopsies were performed below the waist compared with above the
waist (P < .02), in the ward compared with the outpatient operating theater (P <
.001), in smokers compared with nonsmokers (P < .001), and in those taking
corticosteroids compared with those who were not (P < .001). In addition,
elliptical incisional biopsies developed complications more frequently when
subcutaneous sutures were not used compared with when they had been used (P <
.001).
CONCLUSIONS: This study has demonstrated a high rate of wound complications after
diagnostic dermatologic surgery on dermatology inpatients with significant host
and procedural risk factors. These findings are relevant for other centers with
inpatient units where diagnostic biopsies are performed.
DOI: 10.1001/archderm.143.10.1267
PMID: 17938340 [Indexed for MEDLINE]
