Risk, Prevention, Diagnosis, and Management of Post-Operative Cutaneous Infection

Abstract

Dermatologic surgery procedures have low but non-negligible infection rates. This review summarizes current understanding of the risk of post-operative wound infections after cutaneous surgery, the diagnosis and management of post-operative infections, and appropriate use of antibiotic prophylaxis in dermatologic surgery. Aside from specific situations associated with risk for infective endocarditis, prosthetic joint infections, and high-risk cutaneous surgeries, routine prophylactic, or post-operative antibiotic use is no longer the standard of care. Preliminary data suggests that post-operative infections may be more related to patient factors such as microbial colonization than technique-related factors. Several recent studies have suggested that outcomes may be equivalent between clean and sterile surgical technique for office-based cutaneous surgery. The past decade has seen a shift away from routine use of prophylactic and post-operative antibiotics in dermatologic surgery. Clinicians should be aware of the indications for prophylaxis and avoid unnecessary prescribing of antibiotics.