A guide to anticoagulation and endocarditis prophylaxis during cutaneous surgery

Area of Science:

• Dermatology
• Cardiology
• Infectious Diseases

Background:

• Perioperative management of antiplatelet/anticoagulation drugs and antibiotic prophylaxis for endocarditis are controversial in cutaneous surgery.
• Recent guidelines from major health organizations have updated recommendations for these practices.

Purpose of the Study:

• To review current best practices for managing antiplatelet/anticoagulation drugs and antibiotic prophylaxis in cutaneous surgery.
• To provide evidence-based guidance for clinicians facing these common dilemmas.

Main Methods:

• Literature review of current guidelines and studies.
• Analysis of recommendations from the National Institute of Health and Clinical Excellence (NICE), American Heart Association, and European Society of Cardiology.

Main Results:

• Antiplatelet agents should generally be continued perioperatively, with exceptions for primary cardiovascular disease (discontinue 1 week prior).
• Warfarin can be continued if the international normalised ratio (INR) is < 3.
• Routine perioperative antibiotics for endocarditis prophylaxis are not recommended unless surgical site infection is evident.

Conclusions:

• Optimizing perioperative medication management and antibiotic use in cutaneous surgery requires careful consideration of individual patient factors and current evidence-based guidelines.
• Adherence to updated recommendations can improve patient safety and reduce the risk of complications such as bleeding and endocarditis.