Why Are Antibiotics Given Before Cutaneous Surgery? (original) (raw)

What are prophylactic antibiotics?

Prophylactic or preemptive antibiotic treatments are administered prior to skin surgery in people who have compromised immunity or other conditions that make them prone to infection.

Prophylactic or preemptive antibiotic treatments are administered prior to skin surgery in people who have compromised immunity or other conditions that make them prone to infection.

Prophylactic antibiotics are antimicrobial medications administered to prevent possible infection that may result from exposure to microorganisms during certain medical procedures. Prophylactic antibiotics are administered as a preemptive measure, mostly to people who are at a high risk for a potential infection.

When should antibiotics be given for cutaneous surgery?

Prophylactic antibiotics are usually given as a single intravenous dose approximately an hour before the procedure so that the tissues are adequately infiltrated with the antibiotic when surgery begins. Surgeries that take longer than four hours may require additional antibiotic doses.

Prophylactic antibiotics are generally discontinued within 24 hours after completion of surgery. Some patients may, however, require postoperative treatment with antibiotics if the surgical wound develops an infection.

Why are antibiotics given before skin (cutaneous) surgery?

Antibiotics are given before a dermatologic surgery because the tissue and blood vessels under the skin are exposed to microbes when a skin incision is made. Use of antibiotics before a cutaneous surgery is particularly important for patients who are immune-compromised or otherwise face a high risk from infections.

Skin is the first-line defense against germs and forms a barrier against harmful pathogens from the environment. Skin harbors several bacteria species (skin flora), both resident and transient. Even though antiseptic scrubbing can reduce the skin flora, approximately 20% remain on the skin. These otherwise harmless microbes -- some are even beneficial in normal circumstances -- may become deadly when they enter exposed tissue and the bloodstream.

Are antibiotics necessary before cutaneous surgery?

Not everyone requires antibiotics before a clean cutaneous surgery. Most dermatologic procedures are of short duration and have a low infection risk in healthy people.

When prophylactic antibiotics are used for skin surgery in mostly healthy people, it’s usually because an incision is necessary in the mucous membranes of the mouth, throat or sinuses. It is not possible to adequately sterilize these tissues with topical antibacterial agents.

The use of antibiotics in cutaneous surgery should be individualized and given after evaluating the potential for infection and the risk for development of antibiotic-resistant organisms.

IMAGES Eczema Browse our medical image collection of allergic skin disorders such as psoriasis and dermatitis and more caused by allergies See Images

Who should be given antibiotics before a cutaneous surgery?

Antibiotics are essential for certain patients who are at a higher risk for developing infections from bacteria in the bloodstream (bacteremia). Following are the primary reasons for antibiotic use before cutaneous surgery:

Prevention of infective endocarditis

Endocarditis is the infection of the inner heart tissue (endocardium), which is an uncommon but potentially life-threatening condition that can result from a surgical site infection. People at risk for infective endocarditis include patients who have:

Prevention of hematogenous total joint infection

Some patients who have total joint replacements are at high risk for developing infection in the prosthetic joints from bacteremia. Patients with prosthetic joints who are at high risk include those who also:

People who are immune compromised

Some diseases make it easier to contract an infection, conditions such as:

Prevention of surgical site infection

The chances of surgical site infection from a cutaneous surgery is very low in most people if rigorous hygiene is followed during and after the procedure. Still, some bacteria may still enter the wound through skin cells or aerosolized water droplets, but a healthy immune system can fight these bacteria successfully.

The risk factors for surgical site infections include the following:

Antibiotics are used after a cutaneous procedure usually only if an infection develops. The symptoms of wound infection include:

Treatment of wound infection usually requires antibiotics that are also active against methicillin-resistant Staphylococcus aureus (MRSA).

Health News

Are antibiotics necessary after Mohs surgery?

Mohs micrographic surgery is a procedure to remove cancerous lesions in the skin. Mohs surgery is a sterile procedure and is safe for most people, but patients with high risk for infection may require antibiotics.

Risk factors from Mohs surgery include:

Multimedia: Slideshows, Images & Quizzes

IMAGES Eczema Browse our medical image collection of allergic skin disorders such as psoriasis and dermatitis and more caused by allergies See Images

Treatment & Diagnosis

Medications & Supplements

Medically Reviewed by a Doctor on 9/25/2020

Health News

Subscribe to MedicineNet's Skin Care & Conditions Newsletter

By clicking "Submit," I agree to the MedicineNet Terms and Conditions and Privacy Policy. I also agree to receive emails from MedicineNet and I understand that I may opt out of MedicineNet subscriptions at any time.

FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References

Medscape Medical Reference