The effect of antibiotic prophylaxis on infection rates in mohs micrographic surgery: a single-institution...

Area of Science:

• Dermatology
• Surgical Oncology
• Infectious Disease

Background:

• Antibiotic prophylaxis (AP) guidelines for dermatologic surgery, including Mohs micrographic surgery (MMS), lack consistent recommendations.
• Variations in AP practices may influence postoperative infectious complications.

Purpose of the Study:

• To evaluate the effect of different antibiotic prophylaxis regimens (pre-/intra-operative, post-operative, or none) on infectious complications in patients undergoing MMS.
• To assess the incidence of surgical site infections (SSI), prosthetic joint infections, and infective endocarditis following MMS.

Main Methods:

• A single-institution retrospective cohort study analyzed 2,364 patient encounters treated with MMS.
• Bivariate logistic regression was used to examine associations between patient/operative characteristics, AP use, and infectious complications.
• Patients were categorized by AP use: none (85.8%), post-operative (10.0%), or pre-/intra-operative (4.1%).

Main Results:

• The overall SSI rate was 1.3%, with no significant difference observed between groups receiving no AP, post-operative AP, or pre-/intra-operative AP.
• Repairs utilizing porcine xenografts and interpolation/pedicle flaps were associated with increased SSI risk.
• No cases of infective endocarditis or prosthetic joint infection were reported in any AP group.

Conclusions:

• Antibiotic prophylaxis does not appear to alter the risk of SSI, infective endocarditis, or prosthetic joint infection in patients undergoing Mohs micrographic surgery.
• Surgical factors like graft type and flap reconstruction may be more influential in SSI development.
• Further research with larger, multi-institutional studies may be warranted to confirm these findings.