Skin Flora Isolates in Organ-Space Surgical Site Infections After Hepatectomy: A Single-Center Retrospective Case Series
I. A. Gilca1*, S. T. Mees1, A. Ghinagow1
1Department of General and Visceral Surgery, Städtisches Klinikum Dresden, Dresden, Germany.
*Corresponding Author: Iulian-Andrei Gilca, Department of General and Visceral Surgery, Städtisches Klinikum Dresden, Dresden, Germany.
DOI: https://doi.org/10.58624/SVOAMR.2026.04.017
Received: August 05, 2026
Published: August 20, 2026
Citation: Gilca IA, Mees ST, Ghinagow A. Skin Flora Isolates in Organ-Space Surgical Site Infections After Hepatectomy: A Single-Center Retrospective Case Series. SVOA Medical Research 2026, 4:4, 148-155. doi: 10.58624/SVOAMR.2026.04.017
Abstract
Background: The clinical relevance of skin flora isolates (e.g., Cutibacterium acnes, coagulase-negative staphylococci) in post-hepatectomy organ-space surgical site infections (SSIs) remains unclear.
Methods: A retrospective, observational analysis of a single-center database was conducted. We analysed patients developing organ-space SSIs following hepatectomy, stratifying them by microbiological culture results.
Results: Among 278 hepatectomies (140 open, 138 laparoscopic), 17 clinically and radiologically defined organ-space SSIs occurred. Of the 13 culture-positive SSIs, 7 (53.8%) yielded skin flora predominantly, while 6 (46.2%) yielded classical intra-abdominal or non-skin pathogens. Four cases were culture-negative. Skin flora SSIs presented later (median POD 12 vs POD 8) and were associated with longer prophylactic drain durations (7.5 vs 6.0 days). Skin flora SSIs occurred slightly more often following open surgery (5/140) compared to laparoscopic (2/138), though this remains a purely exploratory observation given the small sample size and potential confounders. Both skin flora and non-skin flora SSIs were managed successfully with percutaneous drainage and antibiotics, with 0% reoperation and 0% infection-related mortality in both subgroups.
Conclusions: Skin flora organisms frequently colonize or infect post-hepatectomy fluid collections. Given the uniformly high success rate of conservative management (drainage and antibiotics) in this cohort, these isolates might represent a distinct, less virulent clinical entity, though distinguishing true infection from drain contamination remains challenging. Prospective validation is required.
Keywords: Hepatectomy, Surgical site infection, Skin flora, Postoperative infection