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Immunosuppression ups risk of complications after Mohs micrographic surgery

15 Jun 2019
A deadly bacterial infection has been found to be affecting many stillborn and infants.

Immunosuppressed patients are at increased risk for postoperative complications, such as surgical site infection and wound dehiscence, following Mohs micrographic surgery (MMS) due to solid organ transplant and immunosuppressive therapy use, according to a new study.

In univariable analysis, immunosuppression correlated with 9.6-fold increased odds of postoperative complication (p=0.003) compared with immunocompetence, with solid organ transplant recipients having 8.824 times higher odds (p=0.006) and immunosuppressive therapy users showing 5.775 times higher odds (p=0.021). Immunosuppressed patients were at increased risk of surgical site infection (2.5 percent) and dehiscence (0.51 percent), with an overall complication rate of 5.4 percent in the said population.

Multivariable analysis showed a statistically nonsignificant association between immunosuppression and postoperative complication (p=0.056).

An earlier study also found a higher risk for complications in large tumours following MMS owing to their increased size and need for repair with methods other than linear closures. In contrast, tumours with aggressive subclinical extension were not at greater risk for postoperative complications. [J Drugs Dermatol 2018;17:511-515]

The investigators conducted a retrospective cross-sectional chart review of patient characteristics, clinical characteristics and complications to determine the incidence and nature of postoperative complications in immunosuppressed patients undergoing MMS.

The study was limited by its single-centre, retrospective design, as well as the lack of nonsolid organ transplants, limited medication-related data on nontransplant patients, and exclusion of cases involving patients with double transplants or multiple sources of immunosuppression.

“Many patients undergoing MMS for basal and squamous cell carcinomas are immunocompromised, yet postoperative complications associated with different types of immunosuppression are largely unstudied,” the investigators said.

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Most Read Articles
4 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Roshini Claire Anthony, 6 days ago

Women who receive a single dose of amoxicillin and clavulanic acid within 6 hours of operative vaginal delivery could significantly reduce their postpartum infection risk, according to the UK-based ANODE* trial.

Pearl Toh, Yesterday
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
4 days ago
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.