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Surgical Site Infections in Dermatologic Surgery- Clinical, diagnostic, and pathogenic aspects

Saleh, Karim LU (2019) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2019:14(14).
Abstract
Surgical site infections (SSIs) in dermatologic surge- ry contribute to unwanted healthcare costs and are complications that cause su ering in patients. The aim of this thesis was to explore clinical, diagnos- tic, and pathogenic aspects of SSIs in dermatologic surgery.
In study I, we examined bacterial dynamics during normal wound healing and SSIs. We found that quantifying bacteria from wounds was a relevant factor for assessing healing outcomes. Higher bac- terial loads in wounds resulted in complicated post- operative healing outcomes.
In study II, we designed a randomized controlled trial exploring the e ects of a novel antiseptic, po- lyhexanide biguanide (PHMB) on bacterial loads. PHMB added to tie-over dressings in... (More)
Surgical site infections (SSIs) in dermatologic surge- ry contribute to unwanted healthcare costs and are complications that cause su ering in patients. The aim of this thesis was to explore clinical, diagnos- tic, and pathogenic aspects of SSIs in dermatologic surgery.
In study I, we examined bacterial dynamics during normal wound healing and SSIs. We found that quantifying bacteria from wounds was a relevant factor for assessing healing outcomes. Higher bac- terial loads in wounds resulted in complicated post- operative healing outcomes.
In study II, we designed a randomized controlled trial exploring the e ects of a novel antiseptic, po- lyhexanide biguanide (PHMB) on bacterial loads. PHMB added to tie-over dressings in full-thickness skin grafting did not decrease bacterial loads and paradoxically increased the incidence of SSIs in the intervention group.
In study III, we examined whether wound uids obtained from dermatosurgical wounds could pre- dict the occurrence of an SSI. Our results showed that the investigated biomarkers could indeed ser- ve as diagnostics for assessing wound healing.
In study IV, the aim of the study was to assess in- ter-observer agreement when assessing wound healing in dermatologic surgery. There was a bro- ad inter-observer variability in the diagnosis of an SSI illustrating the need for objective diagnostic methods that capture an actual SSI.
Ultimately, we provided new insights into SSIs in dermatologic surgery that can be useful in discove- ring methods to prevent these types of infections in the future.
Keywords: Surgical site infections (SSIs), derma- tologic surgery, full-thickness skin grafting, acute wounds, wound healing, microbiome, diagnostics, prevention, pathogenesis. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • professor Nagore, Eduardo, Instituto Valenciano de Oncologia, Spain
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Surgical site infections (SSIs), dermatologic surgery, full-thickness skin grafting, acute wounds, wound healing, microbiome, diagnostics, prevention, pathogenesis
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2019:14
issue
14
pages
72 pages
publisher
Lund University: Faculty of Medicine
defense location
Segerfalksalen, BMC A10, Sölvegatan 17 i Lund
defense date
2019-02-01 13:00:00
external identifiers
  • scopus:85065838011
ISSN
1652-8220
ISBN
978-91-7619-743-1
language
English
LU publication?
yes
id
2c54f6be-3e7d-46da-9b5b-b2e8e9a08f7f
date added to LUP
2018-12-18 23:47:15
date last changed
2021-03-31 05:35:25
@phdthesis{2c54f6be-3e7d-46da-9b5b-b2e8e9a08f7f,
  abstract     = {Surgical site infections (SSIs) in dermatologic surge- ry contribute to unwanted healthcare costs and are complications that cause su ering in patients. The aim of this thesis was to explore clinical, diagnos- tic, and pathogenic aspects of SSIs in dermatologic surgery.<br/>In study I, we examined bacterial dynamics during normal wound healing and SSIs. We found that quantifying bacteria from wounds was a relevant factor for assessing healing outcomes. Higher bac- terial loads in wounds resulted in complicated post- operative healing outcomes.<br/>In study II, we designed a randomized controlled trial exploring the e ects of a novel antiseptic, po- lyhexanide biguanide (PHMB) on bacterial loads. PHMB added to tie-over dressings in full-thickness skin grafting did not decrease bacterial loads and paradoxically increased the incidence of SSIs in the intervention group.<br/>In study III, we examined whether wound  uids obtained from dermatosurgical wounds could pre- dict the occurrence of an SSI. Our results showed that the investigated biomarkers could indeed ser- ve as diagnostics for assessing wound healing.<br/>In study IV, the aim of the study was to assess in- ter-observer agreement when assessing wound healing in dermatologic surgery. There was a bro- ad inter-observer variability in the diagnosis of an SSI illustrating the need for objective diagnostic methods that capture an actual SSI.<br/>Ultimately, we provided new insights into SSIs in dermatologic surgery that can be useful in discove- ring methods to prevent these types of infections in the future.<br/>Keywords: Surgical site infections (SSIs), derma- tologic surgery, full-thickness skin grafting, acute wounds, wound healing, microbiome, diagnostics, prevention, pathogenesis.},
  author       = {Saleh, Karim},
  isbn         = {978-91-7619-743-1},
  issn         = {1652-8220},
  language     = {eng},
  number       = {14},
  publisher    = {Lund University: Faculty of Medicine},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {Surgical Site Infections in Dermatologic Surgery- Clinical, diagnostic, and pathogenic aspects},
  url          = {https://lup.lub.lu.se/search/ws/files/56861081/Karim_Saleh.Doctoral.thesis.no_studies_attached.pdf},
  volume       = {2019:14},
  year         = {2019},
}