The surgical treatment of non-metastatic melanoma in a Clinical National Melanoma Registry Study Group (CNMR): a retrospective cohort quality improvement study to reduce the morbidity rates

Abstract Background Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry. Methods Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (> 80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated. Results Wound infection rate was 1.1% (0.4 to 2.7%) in WE, 1.3% (0.7 to 2.5%) in SLNB and 4.1% (2.1 to 8.0%) in LFND. Wound dehiscence rate was 2.0% (0.8 to 5.1%) in WE, 0.9% (0.2 to 3.0%) in SLNB and 2.8% (0.9 to 8.6%) in LFND. Seroma rate was 4.2% (1.5 to 11.1%) in SLNB and 15.1% (4.6 to 39.9%) in LFND. Unreliable information was found on skin graft failure. Conclusions Our findings contribute to available literature in setting up the recommended standards for melanoma centers, thus improving the quality of surgery offered to patients. A consensus on the core issues around surgical morbidity is needed to provide practical guidance on morbidity prevention and management.

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The Surgical Treatment of Non-Metastatic Melanoma in a Multicenter Registry: A Retrospective Cohort Quality Improvement Study to Reduce the Morbidity Rates

10.21203/rs.3.rs-34454/v1 ◽

2020 ◽

Author(s):

Paolo Del Fiore ◽

Simone Mocellin ◽

Marco Rastrelli ◽

Giovanni Battista Damiani ◽

Saveria Tropea ◽

...

Keyword(s):

Surgical Treatment ◽

Wound Infection ◽

Quality Indicators ◽

Skin Graft ◽

Graft Failure ◽

Wound Dehiscence ◽

Wound Infection Rate ◽

Skin Melanoma ◽

Surgical Morbidity ◽

Quality Of Surgery

Abstract Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry.Methods: Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (>80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated.Results: Wound infection rate was 1.1% (0.4% to 2.7%) in WE, 1.3% (0.7% to 2.5%) in SLNB and 4.1% (2.1% to 8.0%) in LFND. Wound dehiscence rate was 2.0% (0.8% to 5.1%) in WE, 0.9% (0.2% to 3.0%) in SLNB and 2.8% (0.9% to 8.6%) in LFND. Seroma rate was 4.2% (1.5% to 11.1%) in SLNB and 15.1% (4.6% to 39.9%) in LFND. Unreliable information was found on skin graft failure.Conclusions: Our findings contribute to available literature in setting up the recommended standards for melanoma centers, thus improving the quality of surgery offered to patients. A consensus on the core issues around surgical morbidity is needed to provide practical guidance on morbidity prevention and management.

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The surgical treatment of non metastatic melanoma in a Clinical National Melanoma Registry Study Group (CNMR): a retrospective cohort quality improvement study to reduce the morbidity rates

10.21203/rs.3.rs-34454/v2 ◽

2020 ◽

Author(s):

Antonella Vecchiato ◽

Simone Mocellin ◽

Paolo Del Fiore ◽

Giulio Tosti ◽

Paolo Antonio Ascierto ◽

...

Keyword(s):

Surgical Treatment ◽

Wound Infection ◽

Quality Indicators ◽

Skin Graft ◽

Graft Failure ◽

Wound Dehiscence ◽

Wound Infection Rate ◽

Skin Melanoma ◽

Surgical Morbidity ◽

Quality Of Surgery

Abstract Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry.Methods: Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (>80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated.Results: Wound infection rate was 1.1% (0.4% to 2.7%) in WE, 1.3% (0.7% to 2.5%) in SLNB and 4.1% (2.1% to 8.0%) in LFND. Wound dehiscence rate was 2.0% (0.8% to 5.1%) in WE, 0.9% (0.2% to 3.0%) in SLNB and 2.8% (0.9% to 8.6%) in LFND. Seroma rate was 4.2% (1.5% to 11.1%) in SLNB and 15.1% (4.6% to 39.9%) in LFND. Unreliable information was found on skin graft failure. Conclusions: Our findings contribute to available literature in setting up the recommended standards for melanoma centers, thus improving the quality of surgery offered to patients. A consensus on the core issues around surgical morbidity is needed to provide practical guidance on morbidity prevention and management.

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The surgical treatment of non-metastatic melanoma in a Clinical National Melanoma Registry Study Group (CNMR): a retrospective cohort quality improvement study to reduce the morbidity rates

10.21203/rs.3.rs-34454/v3 ◽

2020 ◽

Author(s):

Antonella Vecchiato ◽

Simone Mocellin ◽

Paolo Del Fiore ◽

Giulio Tosti ◽

Paolo Antonio Ascierto ◽

...

Keyword(s):

Surgical Treatment ◽

Wound Infection ◽

Quality Indicators ◽

Skin Graft ◽

Graft Failure ◽

Wound Dehiscence ◽

Wound Infection Rate ◽

Skin Melanoma ◽

Surgical Morbidity ◽

Quality Of Surgery

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European Society of Gynaecological Oncology quality indicators for the surgical treatment of endometrial carcinoma

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-003178 ◽

2021 ◽

pp. ijgc-2021-003178

Author(s):

Nicole Concin ◽

François Planchamp ◽

Nadeem R Abu-Rustum ◽

Beyhan Ataseven ◽

David Cibula ◽

...

Keyword(s):

Surgical Treatment ◽

Endometrial Carcinoma ◽

Quality Indicators ◽

European Society ◽

Scoring System ◽

Scientific Evidence ◽

Treatment Quality ◽

Standards Of Care ◽

Surgical Morbidity ◽

Gynaecological Oncology

BackgroundQuality of surgical care as a crucial component of a comprehensive multi-disciplinary management improves outcomes in patients with endometrial carcinoma, notably helping to avoid suboptimal surgical treatment. Quality indicators (QIs) enable healthcare professionals to measure their clinical management with regard to ideal standards of care.ObjectiveIn order to complete its set of QIs for the surgical management of gynecological cancers, the European Society of Gynaecological Oncology (ESGO) initiated the development of QIs for the surgical treatment of endometrial carcinoma.MethodsQIs were based on scientific evidence and/or expert consensus. The development process included a systematic literature search for the identification of potential QIs and documentation of the scientific evidence, two consensus meetings of a group of international experts, an internal validation process, and external review by a large international panel of clinicians and patient representatives. QIs were defined using a structured format comprising metrics specifications, and targets. A scoring system was then developed to ensure applicability and feasibility of a future ESGO accreditation process based on these QIs for endometrial carcinoma surgery and support any institutional or governmental quality assurance programs.ResultsTwenty-nine structural, process and outcome indicators were defined. QIs 1–5 are general indicators related to center case load, training, experience of the surgeon, structured multi-disciplinarity of the team and active participation in clinical research. QIs 6 and 7 are related to the adequate pre-operative investigations. QIs 8-22 are related to peri-operative standards of care. QI 23 is related to molecular markers for endometrial carcinoma diagnosis and as determinants for treatment decisions. QI 24 addresses the compliance of management of patients after primary surgical treatment with the standards of care. QIs 25–29 highlight the need for a systematic assessment of surgical morbidity and oncologic outcome as well as standardized and comprehensive documentation of surgical and pathological elements. Each QI was associated with a score. An assessment form including a scoring system was built as basis for ESGO accreditation of centers for endometrial cancer surgery.

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A Simple Vacuum Dressing Reduces the Wound Infection Rate of Single-Incision Pediatric Endosurgical Appendectomy

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/108680811x13071180406592 ◽

2011 ◽

Vol 15 (2) ◽

pp. 147-150 ◽

Cited By ~ 11

Author(s):

Oliver J. Muensterer ◽

Richard Keijzer

Keyword(s):

Wound Infection ◽

Infection Rate ◽

Single Incision ◽

Wound Infection Rate

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Surgical Treatment of Chronic Gluteal Hidradenitis Suppurativa: Reused Skin Graft Technique

Dermatologic Surgery ◽

10.1046/j.1524-4725.2003.29044.x ◽

2003 ◽

Vol 29 (2) ◽

pp. 173-178 ◽

Cited By ~ 6

Author(s):

Hung-wen Kuo ◽

Kuniaki Ohara

Keyword(s):

Surgical Treatment ◽

Skin Graft ◽

Hidradenitis Suppurativa

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PS01.184: ESOPHAGEAL CANCER SURGICAL TREATMENT IN BRAZILIAN NATIONAL CANCER INSTITUTE: 25 YEARS EXPERIENCE

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.184 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 102-102

Author(s):

Marco Antonio Guimaraes Filho ◽

Flávio Sabino ◽

Daniel Fernandes ◽

Carlos Eduardo Pinto ◽

Luis Felipe Pinto ◽

...

Keyword(s):

Overall Survival ◽

Esophageal Cancer ◽

Surgical Treatment ◽

Surgical Resection ◽

National Cancer Institute ◽

Conflicts Of Interest ◽

Morbidity Rate ◽

Surgical Mortality ◽

Surgical Morbidity ◽

Hospitalization Time

Abstract Background Esophageal cancer is the 8th most common cancer in the world. It is an lethal disease, responsible for almost 400.000 deaths by year. Surgical resection is considered the gold standard in esophageal cancer treatment, with a global 15–40% cure rate. In this study, the results of esophageal cancer surgical treatment at Brazilian National Cancer Institute, Abdominal-pelvic Surgical Section, is analyzed. Methods The medical records of 215 patients with esophageal cancer, treated with surgical resection (esophagectomy), between January 1999 and December 2015, were retrospectively studied. The endpoints analyzed in the study were: hospitalization time, operative complications and mortality, and overall survival. Results Esophageal cancer was predominant in male patients; median age was 58 years (27–78). Primary tumor location varied between 7,5 - 41 cm (median 32cm) and tumor extension 1 - 16cm (median 5cm). Median surgical time was 330 minutes (120–720); transhiatal esophagectomy with gastric tube reconstruction was the most used surgical approach. Tumors histopathological types were equaly distributed. ICU (Intensive Care Unit) stay median time was 5 days (1–87) and median hospitalization time was 15 days (5–166). Most common surgical complications were anastomotic leakage (25,5%) and pneumonia (20%), with a surgical morbidity rate of 61,8%. Surgical mortality rate was 12%, with 61% of these cases occuring in the 30 days after surgery. Median 2-year overall survival was 44,3 months. Conclusion Besides the high surgical morbidity, esophagectomy for esophageal cancer remains the standard treatment for patients with ressectable tumors and without clinical contraindications for surgery. Reduction of surgical mortality depends on rigorous patients selection, surgical team expertise and adequate perioperative and postoperative care. Disclosure All authors have declared no conflicts of interest.

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Wound Infection Rate in Dermatologic Surgery

The Journal of Dermatologic Surgery and Oncology ◽

10.1111/j.1524-4725.1988.tb01147.x ◽

1988 ◽

Vol 14 (5) ◽

pp. 525-528 ◽

Cited By ~ 47

Author(s):

DUANE C. WHITAKER ◽

DONALD J. GRANDE ◽

SALLY S. JOHNSON

Keyword(s):

Wound Infection ◽

Infection Rate ◽

Wound Infection Rate ◽

Dermatologic Surgery

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Simultaneous surgery for primary and nodes in carcinoma penis: a rural tertiary medical centre experience and results

International Surgery Journal ◽

10.18203/2349-2902.isj20174517 ◽

2017 ◽

Vol 4 (10) ◽

pp. 3466

Author(s):

Senthil Kumar A. C. ◽

Rajesh S.

Keyword(s):

Hospital Stay ◽

Wound Infection ◽

Retrospective Analysis ◽

Wound Infection Rate ◽

Medical Centre ◽

Previous Therapy ◽

Simultaneous Surgery ◽

Simultaneous Procedure ◽

The Mean ◽

Carcinoma Penis

Background: Historically surgery for nodes in carcinoma penis was done as staged procedure due to fear of higher morbidity and longer hospital stay. However, in view of the established safety of the simultaneous procedure, very few centres do simultaneous surgery for nodes and primary in cancer penis.Methods: A retrospective analysis of all the simultaneous surgeries for nodes and primary for carcinoma penis done at our hospital, during the period April 2015 to March 2017 were done and various parameters were calculated and compared with historical standards of various series.Results: The various parameters namely wound morbidity, hospital stay and complications were analysed and compared with historical standards. A total of 15 patients during the above mentioned were found to be suitable for the analysis after having excluded patients who had previous therapy and inoperable tumours. The mean follows up period was 12 months (ranging from 8 to 20 months). The mean hospital stay was 15 days (range from 12 days to 25 days). The skin margin necrosis rate was 6.67%, wound infection rate was 6.67% and there were no perioperative deaths. The same was compared with historical standards.Conclusions: Simultaneous surgery for primary and nodes in carcinoma penis is safe and the standard results are reproducible in a rural tertiary medical centre like ours.

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WOUND INFECTION

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.01.1983 ◽

2010 ◽

Vol 17 (01) ◽

pp. 64-67

Author(s):

UZMA HUSSAIN ◽

AFSHAN SAEED ◽

FARZANA LATIF

Keyword(s):

Cesarean Section ◽

Wound Infection ◽

Wound Dehiscence ◽

Severe Anaemia ◽

Medical College ◽

Emergency Cesarean ◽

Section Design ◽

Elective Cesarean ◽

Wound Discharge ◽

Very High

Objective: To evaluate the effects of the anaemia in wound infection after cesarean section. Design: Prospective study. Setting:Department of Obstetric-Gynaecology in Sir Ganga Ram Hospital / Fatima Jinnah Medical College Lahore. Period: Sep 2008 to Sep 2009.Patients and Methods: The study comprises of 100 pregnant women with moderate to severe anaemia. Selected cases underwent cesareansection due to different indications. The rate and frequency of wound infection was observed in all these women. Results were analysed andtabulated. Results: 100 cases with moderate to severe anaemia who underwent cesarean section were included. Moderate aneamia wasrecognized in 55% of cases and 19% with severe anaemia. Wound discharge was seen in 44 % of cases and wound dehiscence was foundin 56 % cases. Culture was positive in 41 % patients and majority of these were unbooked. Non elective cesarean delivery was performed in99% of cases. Conclusion: The rate of wound infection was very high in moderate to severely anemic women who underwent non elective/ emergency cesarean section.

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