title: Postoperative infection after excisional toenail matrixectomy: a retrospective clinical audit.
abstract: BACKGROUND
  Excisional toenail matrixectomies are performed on the area of the foot that has been reported to have the highest concentration of resident microorganisms. A retrospective infection audit was performed to identify whether this unique area of the foot was more susceptible to postoperative infection.
  
  
  METHODS
  A retrospective audit reviewing the postoperative infection rate over a 6-year period after excisional nail matrixectomy in 111 patients was undertaken.
  
  
  RESULTS
  The postoperative infection rate was found to be high (18.9%) relative to that of clean orthopedic foot and ankle surgery (0.5%-6.5%).
  
  
  CONCLUSIONS
  The unique concentration of resident microbes found in the nail folds could help explain the high rate of postoperative infections identified in this study. This may provide some argument to classify excisional nail matrixectomy as clean-contaminated surgery and, thus, warrant routine antibiotic prophylaxis. Further research is recommended to confirm the results of this study and to determine whether appropriately timed oral antibiotic prophylaxis will reduce the infection rate after nail surgery.
authors.affiliation: Podiatry Outpatients, Repatriation General Hospital, Daw Park, South Australia, Australia. arusmir@gmail.com
authors.forename: Alen
authors.initials: A
authors.lastname: Rusmir
authors.forename: Angelo
authors.initials: A
authors.lastname: Salerno
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods*; D054869:Clinical Audit; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013511:Minor Surgical Procedures / Q000706:statistics & numerical data; D009263:Nails, Ingrown / Q000175:diagnosis / Q000601:surgery*; D011032:Podiatry / Q000379:methods / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013021:South Australia; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014034:Toes / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents