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Infections Rare After Mohs Micrographic Surgery

Surgeons urged to rethink practice of prescribing the antibiotics indiscriminately

MONDAY, July 28 (HealthDay News) -- Surgical site infections are extremely uncommon in patients undergoing Mohs micrographic surgery for non-melanoma skin cancer or modified Mohs micrographic surgery for lentigo maligna melanoma in situ, suggesting that the routine administration of antibiotics may be unnecessary, according to a study published in the August issue of the Journal of the American Academy of Dermatology.

Sherry L.H. Maragh, M.D., of the University of Rochester Medical Center and Strong Memorial Hospital in Rochester, N.Y., and a colleague studied 1,000 patients with 1,115 tumors.

The researchers identified only eight infections for an overall wound infection rate of 0.7 percent. Of these infections, five occurred on the nose, seven occurred after flap reconstruction and four occurred in patients requiring more than one Mohs stage for tumor clearance. In two infections, cultures tested positive for oxacillin-resistant Staphylococcus aureus.

"It is the responsibility of the surgeon to evaluate these factors in addition to patient and environmental factors on a case-by-case basis," the authors conclude. "Surgical site infection prophylaxis must always be considered in those patients in whom the morbidity of a surgical site infection exceeds the risk of any potential adverse effects of antibiotic therapy. With the recent increase in antimicrobial-resistant organisms in the community, and as demonstrated in this study, it is our responsibility to be judicious in the administration of antibiotics for the prophylaxis of surgical site wound infections."

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