Effect of a Single Preoperative Dose of Oral Antibiotic to Reduce the Incidence of Surgical Site Infection Following Below-Knee Dermatological Flap and Graft Repair

• Published in: Dermatology practical & conceptual 2019-01, Vol.9 (1), p.28-35
• Main Authors: Rosengren, Helena, Heal, Clare F, Buettner, Petra G
• Format: Article
• Language: English
• Subjects: antibiotic prophylaxis; dermatological surgical wound infection; grafts; operative surgical procedures; surgical site infection
• ISSN: 2160-9381; 2160-9381
• DOI: 10.5826/dpc.0901a08

Surgical site infection (SSI) rates for below-knee dermatological surgery are unacceptably high, particularly following complex flap and graft closures. The role of antibiotic prophylaxis for these surgical cases is uncertain. To determine whether SSI following complex dermatological closures on the leg could be reduced by antibiotic prophylaxis administered as a single oral preoperative dose. A total of 115 participants were randomized to 2 g of oral cephalexin or placebo 40-60 minutes prior to surgical incision in a prospective, randomized, double-blind, placebo-controlled trial at a primary care skin cancer clinic in North Queensland, Australia. Overall 17/55 (30.9%) controls and 14/55 (25.5%) intervention participants developed infection (P = 0.525). There was no difference between the study groups in adverse symptoms that could be attributed to high-dose antibiotic administration (P = 1). A single oral 2-g dose of cephalexin given before complex below-knee dermatological closure did not reduce SSI.