Prospective Study of Wound Infections in Dermatologic Surgery in the Absence of Prophylactic Antibiotics

Prospective study of wound infections in Mohs micrographic surgery using clean surgical technique in the absence of prophylactic antibiotics

“…[5][6][7][8][9][10][11]13,15,16 Six of these studies include at least control arms where no antibiotic prophylaxis was used and the rates of SSIs remained low (0.72%-4.25%), providing strong evidence that antibiotics are not warranted for the majority of dermatologic surgery cases. [7][8][9][10]15,16 Yet, all of the studies to date used sterile technique at least during the wound reconstruction phase of the dermatologic surgeries. Our study is the first to identify the rate of SSI using clean surgical technique for all steps of MMS, including wound reconstruction, without antibiotic prophylaxis or topical antibiotics for postoperative wound care.…”

“…6,7 More recently, 3 studies have illustrated that this low rate of SSI is achievable without the use of prophylactic antibiotics, finding SSIs in 0.7%, 1.47%, and 1.8% of dermatologic surgeries. [8][9][10] When comparing these studies, each has its own surgical protocol to prevent infection. This variation can also be found when comparing the practices of Mohs surgeons.…”

Cutaneous changes of nephrogenic systemic fibrosis: Predictor of early mortality and association with gadolinium exposure

“…Each biopsy specimen demonstrated histologic evidence of NSF, lending validity to our skin scoring system. We intentionally limited our analysis for NSF to a noninvasive skin examination so as to maximize the number of patients who would participate and to avoid the less than trivial infectious complications of a full-thickness (often lower extremity) skin biopsy (20,21), especially given that the patients in this study universally had renal failure and a high prevalence of skin fibrosis and diabetes mellitus, which are known risk factors for surgical wound infection and poor wound healing (22)(23)(24). By not requiring a skin biopsy, we were able to achieve a 94% participation rate and to minimize selection bias.…”

Antibiotic prophylaxis in dermatologic surgery: Advisory statement 2008

“…In one study, 5091 lesions on 2424 patients were surgically removed over a span of 3 years. 19 None of the patients received prophylactic antibiotics, and rates of infection were determined. This study concluded that several scenarios resulted in an unacceptably high surgical site infection rate, over 5% (Table VI).…”