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Prophylaxis for Wound Infections and Endocarditis

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Complications in Cutaneous Surgery

Abstract

There are three instances when prophylactic antibiotics are indicated: prophylaxis for prevention of a sugical site infection (SSI), prevention of endocarditis, and prevention of prosthesis infection. Postoperative SSI are a serious complication in cutaneous surgery, and although some limited guidelines exist, many physicians are unaware of the proper use of antibiotics.13 Furthermore, the emergence of resistant bacteria makes the prudent use of antibiotics crucial. A thorough understanding of the various factors related to SSI prophylaxis, the Centers for Disease Control and Prevention (CDC) guidelines pertaining to SSI prophylaxis, and proper antibiotic usage is vital to the practice of cutaneous surgery and will be discussed in this chapter. Treatment of definitive SSI is discussed in Chapter 5.

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References

  1. Scheinfeld N, Struach S, Ross B. Antibiotic prophylaxis guideline awareness and antibiotic prophylaxis use among New York State dermatologic surgeons. Dermatol Surg 2002;28:841–844.

    Article  PubMed  Google Scholar 

  2. George PM. Dermatoligsts and antibiotic prphylaxis: a survey. J Am Acad Dermatol 1995;33:418–421.

    Article  CAS  PubMed  Google Scholar 

  3. Maragh SL, et al. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg 2005;31:83–93.

    CAS  PubMed  Google Scholar 

  4. Rabb DC, Lesher JL Jr. Antibiotic prohylaxis in cutaneous surgery. Dermatol Surg 1995;33:418–421.

    Google Scholar 

  5. Messingham MJ, Arpey CJ. Update on the use of antibiotics in cutaneous surgery. Dermatol Surg 2005;31:1068–1078.

    Article  CAS  PubMed  Google Scholar 

  6. Hass AF, Grekin RC. Antibiotic prophylaxis in dermatologic surgery. J Am Acad Dermatol 1995;32:155–176.

    Article  Google Scholar 

  7. Billingsley E. The role of antibiotics in cutaneous surgery. Available at: http://www.emedicine.com/derm/topic821.htm. Accessed October 2006.

    Google Scholar 

  8. Centers for Disease Control and Prevention. Guideline for prevention of surgical site infection, 1999. Available at: http://www.cdc.gov. Accessed October 2006.

    Google Scholar 

  9. National Nosocomial Infection Survey (NNIS). Report, October 2004. Available at: http://www.cdc.gov/ncidod/dhqp/nnis_pubs.html. Accessed October 2006.

    Google Scholar 

  10. Salache SJ. Acute surgical complications: cause, prevention, and treatment. J Am Acad Dermatol 1986;15:1163–1185.

    Article  Google Scholar 

  11. Garner JS. CDC guideline for prevention of surgical wound infections, 1985. Supercedes guideline for prevention of surgical wound infections published in 1982. (Originally published in November 1985). Revised. Infect Control 1986;7(3):193–200.

    CAS  PubMed  Google Scholar 

  12. Hirschmann JV. Antimicrobial prophylaxis in dermatology. Semin Cutan Med Surg 200;19:2–9.

    Article  Google Scholar 

  13. Altemeier WA, et al. American College of Surgeons manual on control of infection in surgical patients. Philadelphia: Lippincott; 1994:133–139.

    Google Scholar 

  14. Cruse PJ, Foord R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am 1980;60:27–40.

    CAS  PubMed  Google Scholar 

  15. Futoryan T, Grande D. Postoperative wound infection rates in dermatologic surgery. Dermatol Surg 1995;21:509–514.

    Article  CAS  PubMed  Google Scholar 

  16. Edwards PS, Lipp A, Holmes A. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database Syst Rev 2004:CD003949.

    Google Scholar 

  17. Kluytmans JA, et al. Nasal carriage of S. aureus as a major risk factor for wound infections after cardiac surgery. J Infect Dis 1995;171:216–219.

    CAS  PubMed  Google Scholar 

  18. Griego RD, Zitelli JA. Intra-incisional prophylactic antibiotics for dermatologic surgery. Arch Dermatol 1998;134:688–692.

    Article  CAS  PubMed  Google Scholar 

  19. Johnson JT, Wagner RL. Infection following uncontaminated head and neck surgery. Arch Otolaryngol Head Neck Surg 1987;113:368–369.

    CAS  PubMed  Google Scholar 

  20. Weber RS, Callender DL. Antibiotic prophylaxis in clean contaminated head and neck oncologic surgery. Ann Otol Rhinol Laryngol 1992;101:16–20.

    Google Scholar 

  21. Alster TS. Against antibiotic prophylaxis for cutaneous laser resurfacing. Dermatol Surg 2000;26:697–698.

    Article  CAS  PubMed  Google Scholar 

  22. Friedman PM, Geronemus RG. Antibiotic prophylaxis in laser resurfacing patients. Dermatol Surg 2000;26:695–697.

    Article  CAS  PubMed  Google Scholar 

  23. Gaspar Z, Vinciullo C, Elliott T. Antibiotic prophylaxis for full-face laser resurfacing: is it necessary? Arch Dermatol 2001;137:313–315.

    CAS  PubMed  Google Scholar 

  24. Manuskiatti W, Fitzpatrick RE, Goldman MP, Krejci-Papa N. Prophylactic antibiotics in patients undergoing laser resurfacing of the skin. J Am Acad Dermatol 1999;40:77–84.

    Article  CAS  PubMed  Google Scholar 

  25. Walia S, Alster TS. Cutaneous CO2 laser resurfacing infection rate with and without prophylactic antibiotics. Dermatol Surg 1999;25:857–861.

    Article  CAS  PubMed  Google Scholar 

  26. Sriprachya-Anunt S, Fitzpatrick RE, Goldman MP, Smith SR. Infections complicating pulsed corbon dioxide laser resurfacing for photoaged facial skin. Dermatol Surg 1997;23:527–535.

    Article  CAS  PubMed  Google Scholar 

  27. Ugburo AO, Atoyebi OA, Oyeneyin JO, Sowemimo GO. An evaluation of the role of systemic antibiotic prophylaxis in the control of burn wound infection at the Lagos University Teaching Hospital. Burns 2004;30:43–48.

    Article  CAS  PubMed  Google Scholar 

  28. Hoffmann S. Siver sulfadiazine: an antibacterial agent for topical use in burns. A review of the literature. Scand J Plast Reconstr Surg 1984;18:119–126.

    Article  CAS  PubMed  Google Scholar 

  29. Monafo WW, West MA. Current treatment recommendations for topical burn therapy. Drugs 1990;40:364–273.

    Article  CAS  PubMed  Google Scholar 

  30. Shirani KZ, Vaughan GM, Mason AD Jr, Pruitt BA Jr. Update on current therapeutic approaches in burns. Shock 1996;5:4–16.

    Article  CAS  PubMed  Google Scholar 

  31. Waldorf HA, Kauvar AN, Geronemus RG. Skin resurfacing of fine to deep rhytides using a char-free carbon dioxide laser in 47 patients. Dermatol Surg 1995;21:940–946.

    Article  CAS  PubMed  Google Scholar 

  32. Weinstein C, Ramirez OM, Pozner JN. Postoperative care following CO2 laser resurfacing: avoiding pitfalls. Plast Reconstr Surg 1997;100:1855–1866.

    Article  CAS  PubMed  Google Scholar 

  33. Beeson WH, Rachel JD. Valacyclovir prophylaxis for herpes simplex virus infection or infection recurrence following laser skin resurfacing. Dermatol Surg 2002;28:331–336.

    Article  PubMed  Google Scholar 

  34. Gilbert S, McBurney E. Use of valacyclovir for herpes simplex virus 1 prophylaxis after facial resurfacing: a randomized clinical trial of dosing regimines. Dermatol Surg 2000;26:50–54.

    Article  CAS  PubMed  Google Scholar 

  35. Gilbert S. Improving the outcome of facial resurfacingprevention of herpes simplex virus type 1 reactivation. J Antimicrob Chemother 2001:47(Suppl T1):29–34.

    Article  CAS  PubMed  Google Scholar 

  36. Perkins SW, Sklarew EC. Prevention of facial herpetic infections after chemical peel and dermabrasion: new treatment strategies in the prophylaxis of patients undergoing procedures of the perioral area. Plast Reconstr Surg 1996;98:427–433.

    Article  CAS  PubMed  Google Scholar 

  37. Bobrow BJ, Pollack CV Jr, Gamble S, Seligson RA. Incision and drainage of cutaneous abscesses is not associated with bacteremia in afebrile adults. Ann Emerg Med 1997;29:404–408.

    Article  CAS  PubMed  Google Scholar 

  38. Smack DP, Harrington AC, Dunn C, et al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial. JAMA 1996;276:972–977.

    Article  CAS  PubMed  Google Scholar 

  39. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens. J Am Acad Dermatol 1998;38:911–918.

    Article  CAS  PubMed  Google Scholar 

  40. Heinrich JJ, Brand DA, Cuono CB. The role of topical treatment as a determinant of infection in outpatient burns. J Burn Care Rehabil 1998;9:253–257.

    Article  Google Scholar 

  41. Campbell RM, Perlis CS, Fisher E, Gloster HM Jr. Gentamicin ointment versus petrolatum for management of auricular wounds. Dermatol Surg 2005;31:664–669.

    Article  CAS  PubMed  Google Scholar 

  42. Huether MJ, Griego RD, Brodland DG, Zitelli JA. Clindamycin for intraincisional antibiotic prophylaxis in dermatologic surgery. Arch Dermatol 2002;138:1145–1148.

    Article  CAS  PubMed  Google Scholar 

  43. Culver DH, Horan TC, Gaynes RP. Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991;16:91(3B):152S–157S.

    Article  Google Scholar 

  44. Perl TM, Golub JE. New approaches to reduce Staphlococcus aureus nosocomial infection rates: treating S. aureus nasal carriage. Ann Pharmacother 1998;32:S7–S16.

    CAS  PubMed  Google Scholar 

  45. Perl TM, Cullen JJ, Wensel RP, et al. Intranasal mupriocin to prevent postoperative S. aureus infections. N Engl J Med 2002;346:1871–1877.

    Article  CAS  PubMed  Google Scholar 

  46. Wenzel RP, Perl TM. The significance of nasal carriage of Staphylococcus aureus and the incidence of post-operative wound infection. J Hosp Infect 1995;31:13–24.

    Article  CAS  PubMed  Google Scholar 

  47. Babcock MD, Grekin RC. Antibiotic use in dermatologic surgery. Dermatol Clin 2003:21:337–348.

    PubMed  Google Scholar 

  48. Gilbert D, et al. Sanford guide to antimicrobial therapy. Antimicrobial Therapy, Inc; 2005:37.

    Google Scholar 

  49. Johns Hopkins Point of Care information technology. Surgical Site Injections. May 23, 2007. Available at: http://hopkinsabxguide.org.

    Google Scholar 

  50. Braun L, Craft D, Williams R, Tuamokumo F, Ottolini M. Increasing clindamycin resistance among methicillinresistant Staphylococcus aureus in 57 northeast United States military treatment facilities. Pediatr Infect Dis J 2005;24:622–626.

    Article  PubMed  Google Scholar 

  51. Cao B, Wang H, Sun H, Zhu Y, Chen M. Risk factors for multlidrug-resistant Pseudomonas aeruginosa nosocomial infection. J Hosp Infect 2004;57:209–216.

    Article  Google Scholar 

  52. Halpern AC, Leyden JJ, Dzubow LM, McGinley KJ. The incidence of bacteremia in skin surgery of the head and neck. J Am Acad Dermatol 1988;19:112–116.

    Article  CAS  PubMed  Google Scholar 

  53. Sabetta JB, Zitelli JA. The incidence of bacteremia during skin surgery. Arch Dermatol 1987;123:213–215.

    Article  CAS  PubMed  Google Scholar 

  54. Maurice PD, Parker S, Azadian BS, Cream JJ. Minor skin surgery. Are prophylactic antibiotics ever needed for curettage? Acta Derm Venereol 1991;71:267–268.

    CAS  PubMed  Google Scholar 

  55. Griffin MR, Wilson WR, Edwards WD, et al. Infective endocarditis: Olmsted County, Minnesota, 1950 through 1981. JAMA 1985;254:1199–1202.

    Article  CAS  PubMed  Google Scholar 

  56. Spelman DW, Weinmann A, Spicer WJ. Endocarditis following skin procedures. J Infect 1993;26:185–189.

    Article  CAS  PubMed  Google Scholar 

  57. Carmichael AJ, Flanagan PG, Holt PJ, Duerden BI. The occurrence of bacteraemia with skin surgery. Br J Dermatol 1996;134:120–122.

    Article  CAS  PubMed  Google Scholar 

  58. Zack L, Remlinger K, Thompson K, Massa MC. The incidence of bacteremia after skin surgery. J Infect Dis 1989;159:148–150.

    CAS  PubMed  Google Scholar 

  59. Dajani AS, Taubert KA, Wilson W, et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA 1997;277:1794–1801.

    Article  CAS  PubMed  Google Scholar 

  60. Durack DT, Kaplan EL, Bisno AL. Apparent failures of endocarditis prophylaxis: analysis of 52 cases submitted to a national registry. JAMA 1983;250:2318–2322.

    Article  CAS  PubMed  Google Scholar 

  61. Cotrufo M, Carozza A, Romano G, De Feo M, Della Corte A. Infective endocarditis of native cardiac valves: 22 years’surgical experience. J Heart Valve Dis 2001;10:478–485.

    CAS  PubMed  Google Scholar 

  62. Mandell GL, Bennett JE, Dolin R, eds. Non-injection drug abusers. In: Principles and practice of infectious diseases. 4th ed. New York: Churchill Livingstone; 1995:753.

    Google Scholar 

  63. Avierinos JF, Gersh BJ, Melton LJ 3rd, et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation 2002;106:1355–1361.

    Article  PubMed  Google Scholar 

  64. Berney P, Fancioli P. Successful prophylaxis of experimental streptoccal endocarditis with single-dose amoxicillin administered after bacterial challenge. J Infect Disease 1990;161:281–285.

    CAS  Google Scholar 

  65. Affleck AG, Birnie AJ, Gee TM, Gee BC. Antibiotic prophylaxis in patients with valvular heart defects undergoing dermatological surgery remains a confusing issue despite apparently clear guidelines. Clin Exp Dermatol 2005;30:487–489.

    Article  CAS  PubMed  Google Scholar 

  66. Wilson WR, Van Scoy RE, Washington JA. Incidence of bacteremia in adults without infection. J Clin Microbiol 1975;2:94–95.

    Google Scholar 

  67. Zack L, Remlinger K, Thompson K, et al. The incidence of bacteremia after skin surgery. J Infect Dis 1989;159:148–150.

    CAS  PubMed  Google Scholar 

  68. Zahariadis G, Ross H. A crusty cause of prosthetic valve endocarditis. Can J Cardiol 1999;15:693–695.

    CAS  PubMed  Google Scholar 

  69. Vanagt WY, Daenen WJ, Delhaas T. Propionibacterium acnes endocarditis on an annuloplasty ring in an adolescent boy. Heart 2004;90:e56.

    Article  CAS  PubMed  Google Scholar 

  70. Harada M, Nishi Y, Tamura S, et al. Infective endocarditis with a huge mitral vegetation related to atopic dermatitis and high serum level of infection-related antiphospholipid antibody; a case report. J Cardiol 2003;42:135–140.

    PubMed  Google Scholar 

  71. Conway DS, Taylor AD, Burrell CJ. Atopic eczema and staphylococcal endocarditis: time to recognize an association? Hosp Med 2000;61:356–357.

    CAS  PubMed  Google Scholar 

  72. Onoda K, Mizutan H, Komada T, et al. Atopic dermatitis as a risk factor for acute native valve endocarditis. J Heart Valve Dis 2000;9:469–471.

    CAS  PubMed  Google Scholar 

  73. Kobayashi H, Sugiuchi R, Tabata N, et al. Guess what! Acute infectious endocarditis with Janeway lesions in a patient with atopic dermatitis. Eur J Dermatol 1999;9:239–240.

    CAS  PubMed  Google Scholar 

  74. Grabczynska SA, Cerio R. Infective endocarditis associated with atopic eczema. Br J Dermatol 1999;140:1193–1194.

    Article  CAS  PubMed  Google Scholar 

  75. Pike MG, Warner JO. Atopic dermatitis complicated by acute bacterial endocarditis. Acta Paediatr Scand 1989;78:463–464.

    Article  CAS  PubMed  Google Scholar 

  76. Americal Dental Association/American Academy of Orthopaedic Surgeons Expert Panel. Antibiotic prophylaxis for dental patients with total joint replacements. AAOS Bull; July 1997. Available at: http://www.aaos.org.

    Google Scholar 

  77. Hirschmann JV. Antimicrobial prophylaxis in dermatology. Semin Cutan Med Surg 2000;19:2–9.

    Article  CAS  PubMed  Google Scholar 

  78. Segreti J, Levin S. The role of prophylactic antibiotics in the prevention of prosthetic device infections. Infect Dis Clin North Am 1989;3:357–370.

    CAS  PubMed  Google Scholar 

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Pipitone, M., Gloster, H.M. (2008). Prophylaxis for Wound Infections and Endocarditis. In: Gloster, H.M. (eds) Complications in Cutaneous Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-73152-0_6

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  • DOI: https://doi.org/10.1007/978-0-387-73152-0_6

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