The incidence of bacteremia in skin surgery of the head and neck
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Cited by (38)
Preventing complications in dermatologic surgery: Presurgical concerns
2021, Journal of the American Academy of DermatologyA double blind, randomised, placebo controlled, feasibility phase III clinical trial of peri-operative immune-enhancing enteral nutrition in patients undergoing surgery for advanced head and neck cancer
2012, e-SPEN JournalCitation Excerpt :In a randomised trial of head and neck cancer patients, Phan et al.,32 reported wound infection rates of 33% after treatment with sulbactam–ampicillin and 21% with clindamycin–amikacin: Rates of bacteraemia were 2% and 4% respectively, whilst rates of bronchopneumonia were 14% and 23%. Similarly, Halpern et al.,33 reported a bacteraemia incidence of 7% in 45 cancer patients undergoing surgery involving the skin of the head and neck. Furthermore, another study,34 which retrospectively reviewed 662 hospital admissions of 169 head and neck cancer patients, found a definite documented infection in 86 febrile episodes, with pneumonia contributing to 40%, bacteraemia to 13%, skin and soft tissue infection to 12%, and tracheobronchitis to 10% of the episodes.
Antimicrobials in dermatologic surgery: Facts and controversies
2010, Clinics in DermatologyCitation Excerpt :Finally, the risk of antibiotic-associated adverse events far exceeds the benefit, if any, from prophylactic antibiotic therapy in most patients with cardiac conditions.17 Given the very low rates of bacteremia in dermatologic surgery associated with scalpel excisions, electrodesiccation, and curettage, Mohs surgery, and hair transplantation, the AHA guidelines can be extended to surgery of the skin.18-20 If the new guidelines sound radical, just look at the guidelines in the United Kingdom, where expert panels have recommended 100% complete elimination of prophylaxis for IE.21
When Antibiotics are Unnecessary
2009, Dermatologic ClinicsCitation Excerpt :First, the incidence of bacteremia, which is the necessary precursor for endocarditis to develop, is low in dermatologic surgery. In five studies including 279 patients,55–59 5 (1.8%) had positive blood cultures: one with S aureus, two with coagulase-negative staphylococci, and two with Propionibacterium acnes. This rate is nearly identical to that recorded in a study of 240 healthy people, in whom 2.1% of blood cultures were positive, mostly with coagulase-negative staphylococci.60
Antibiotic prophylaxis in dermatologic surgery: Advisory statement 2008
2008, Journal of the American Academy of DermatologyCitation Excerpt :The data on the risk of bacteremia during dermatologic surgical procedures is reassuring.1-4 Pooled data from 4 studies on the risk of bacteremia during dermatologic surgery with scalpel excision, electrodesiccation and curettage, Mohs surgery, hair transplantation, flaps and grafts on clinically noninfected, eroded, or intact skin revealed a risk of bacteremia at 1.9% (5/265 subjects).1-4 Of note, 3 of the 5 subjects with positive blood cultures grew organisms (Propionibacterium acnes and Staphylococcus hominis) not typically associated with native valve endocarditis and represent normal skin flora that frequently contaminates blood cultures.4
Complications and Pitfalls of Skin Cancer Surgery/Mohs Micrographic Surgery
2008, Complications in Dermatologic Surgery
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From the Department of Dermatology, Hospital of the University of Pennsylvania.