Postoperative wound infection rates in dermatologic surgery

The revolving door flap could be the reconstructive procedure of choice for the auricular concha following skin cancer excision, based on low risk of necrosis, infection, and postoperative hemorrhage and excellent aesthetic outcomes.

“Qualitative synthesis of the results concluded that the revolving door flap could be the reconstructive procedure of choice for the auricular concha, following skin cancer excision.”

STSG may be used as an alternative to the revolving door flap for conchal bowl reconstruction.

“STSG may be used as an alternative.”

Secondary intention healing poses a greater risk of infection compared to the revolving door flap.

“Secondary intention healing poses a greater risk of infection, as compared to the revolving door flap [2,3,4,5,6,7,8,9,12,18].”

STSG was one of two techniques to present cases of all complications.

“Among the various reconstructive methods examined by the included studies, STSG was one of two techniques to present cases of all complications [2,10,18].”

Futoryan (1995) and Wines (2001), the cohort studies, performed poorly in the risk-of-bias assessment, scoring 4/9 on the Newcastle-Ottawa Scale.

“In stark opposition, Futoryan (1995) [18] and Wines (2001) [2], the cohort studies, performed poorly in the risk-of-bias assessment, scoring 4/9 in the Newcastle–Ottawa Scale, [2,14,18].”

FTSG caused a wide variety of complications, but these findings were discordant across studies.

“Similarly to STSG, FTSG caused a wide variety of complications; however these findings were discordant across studies [2,3,18].”

For secondary intention healing, Futoryan (1995) reported no infections, while Levin (1996) reported 7.1% and Wines (2001) reported 2.8% postoperative infections.

“Futoryan (1995) [18] reported no cases of infection, while 7.1% of patients in Levin (1996) and 2.8% of patients in Wines (2001) developed a postoperative infection [2,12].”

The main issue with secondary intention healing seems to be the risk of infection.

“Postoperative hemorrhage incidence was low, necrosis was nonexistent, and aesthetic outcomes were mostly satisfactory; therefore the main issue with secondary intention healing seems to be the risk of infection [2,12,18].”

STSG should be favored over FTSG due to its comparatively lower incidence of complications and superior cosmetic results.

“Although STSG also has a proclivity to cause complications, it should be favored over FTSG due to its comparatively lower incidence of complications and superior cosmetic results [2,3,10,18].”

Futoryan (1995) reported a 33.3% incidence of infection after FTSG, corresponding to two cases; among four patients without antibiotic prophylaxis, half developed an infection.

“Futoryan (1995) reported a steep 33.3% incidence of infection [18]. Nonetheless, this percentage corresponded to only two cases of infection [18]. Out of the six patients whose auricular conchas were reconstructed using an FTSG in Futoryan (1995), only two received antibiotic prophylaxis; therefore, among four patients without antibiotic prophylaxis, half developed an infection [18].”

FTSG seems to have a tendency to cause complications of all kinds, a propensity that negatively impacts its aesthetic outcomes.

“FTSG seems to have a tendency to cause complications of all kinds, a propensity that negatively impacts its aesthetic outcomes [2,3,18].”

Thuile (2018) did not identify any cases of altered scarring after STSG, and Futoryan (1996) did not find any cases of infection after STSG.

“On the contrary to the findings of Wines (2001), Thuile (2018) did not identify any cases of altered scarring, and Futoryan (1996) did not find any cases of infection [2,10,18].”