Infection prophylaxis in periorbital Mohs surgery and reconstruction: a review and update to recommendations

Mohs micrographic surgery and reconstruction is considered by many as the gold standard for treatment of cutaneous malignancies arising in the periorbital region. It has a high rate of tumor clearance and a low rate of postsurgical complications. One of the most common complications is surgical site infection. Although surgical site infection occurs in less than 3% of patients, it may result in significant morbidity. Considerable research efforts have been devoted to identifying risk factors associated with the development of a postsurgical infection. We examine the impact of endogenous factors (which determine the efficacy of a patient's immune system), exogenous factors (which influence a patient's exposure to bacterial pathogens), and antimicrobial interventions on the incidence of surgical site infection and propose evidence-based recommendations.