Intra-incisional prophylactic antibiotics for dermatologic surgery

Area of Science:

• Dermatology
• Surgical Infections
• Pharmacology

Background:

• Wound infections are a common complication following cutaneous surgery.
• Preventive strategies are crucial to minimize patient morbidity and healthcare costs.

Purpose of the Study:

• To evaluate the efficacy of intra-incisional antibiotics in reducing surgical site infections after dermatologic procedures.
• To assess the safety and convenience of using nafcillin in local anesthesia for cutaneous surgery.

Main Methods:

• A prospective, blinded, randomized, placebo-controlled trial was conducted.
• Patients undergoing Mohs or other dermatologic surgery received local anesthesia with either buffered lidocaine or nafcillin in buffered lidocaine.
• Wound infections were assessed using a standardized chart at suture removal (5-7 days post-surgery).

Main Results:

• A total of 908 surgical wounds were analyzed in 790 patients.
• The incidence of wound infection was significantly lower in the nafcillin group (0.2%) compared to the placebo group (2.5%) (P = .003).
• No adverse effects were reported, and observers remained blinded throughout the assessment.

Conclusions:

• A single intra-incisional dose of nafcillin administered before dermatologic surgery is highly effective in preventing wound infections.
• This antibiotic prophylaxis is an inexpensive, safe, and convenient adjunct to standard surgical care.
• The findings support the routine use of intra-incisional antibiotics in dermatologic surgery to decrease infection rates.