https://orcid.org/0000-0001-5920-6888
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A.G.H. Wernham, G.A. Fremlin, S. Verykiou, N. Harper, S.A. Chan, N. Stembridge, R.N. Matin, R.A. Abbott, Survey of dermatologists demonstrates widely varying approaches to perioperative antibiotic use: time for a randomized trial?, British Journal of Dermatology, Volume 177, Issue 1, 1 July 2017, Pages 265–266, https://doi.org/10.1111/bjd.15025
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Conflicts of interest: none declared.
Dear Editor, The postoperative wound infection rate following dermatological surgery ranges between 0·5% and 8%.1,2,3 Factors reported to increase the risk of surgical‐site infection include procedure type (e.g. wedge excision, full‐thickness skin grafts); anatomical location (e.g. lower limb, groin); tumour ulceration; and patient‐associated factors, such as immunodeficiency, diabetes and smoking.4,5,6 A survey of U.K. dermatologists demonstrated significant variation in the use of perioperative oral antibiotics, dependent upon various factors: presence of ulceration, diabetes, lower‐limb surgery, immunosuppression and flap or graft repairs.7 8 These findings likely reflect a paucity of data in the literature.
While high‐quality evidence is lacking, some dermatological surgeons consider clinical ulceration to be an indication for perioperative antibiotic use.7 8 The frequency of ulcerated skin cancers in routine surgical lists is unknown, yet studies have demonstrated that the presence of ulceration caused by tumour invasion may be associated with a 33% risk of postoperative infection or a threefold increased risk.5 6 In the absence of randomized controlled trial (RCT) data supporting the use of antibiotics, we evaluated the feasibility of developing a trial and aimed to determine rates of ulceration in routine U.K. dermatology surgical lists.
