This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (7)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Dermatology, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Michael J. Huether, MD; Robert D. Griego, MD; David G. Brodland, MD; John A. Zitelli, MD

Arch Dermatol. 2002;138:1145-1148.

Objective  To assess the efficacy of intraincisional clindamycin therapy as an alternative to nafcillin treatment in decreasing the risk of postoperative wound infections in dermatologic surgery.

Design  Prospective, double-blinded, randomized, placebo-controlled trial conducted over a 7-month period.

Setting  Three private practice Mohs micrographic surgery referral centers.

Patients  A total of 1030 consecutive patients who underwent Mohs micrographic surgery with subsequent reconstruction.

Interventions  Prior to reconstruction, patients were randomly assigned to receive either intraincisional buffered lidocaine with epinephrine containing clindamycin or buffered lidocaine with epinephrine without clindamycin. Nurses and physicians who scored the wound at follow-up were blinded to the treatment conditions.

Main Outcome Measures  Surgical wounds evaluated at the time of suture removal were scored according to a standardized assessment based on erythema, edema, and the presence of purulent discharge. Wounds scored 4 or higher were considered to be infected. Bacterial cultures obtained when indicated were also compared.

Results  Of the 1172 surgical wounds included in the study, 29 had wound scores of 4 or higher, 6 in the study group and 23 in the control group (P = .001, Fisher exact test). Of these 29, 18 had culture-positive infections. Four of these occurred in the study group, and 14 occurred in the control group (P = .02, Fisher exact test).

Conclusions  The results of this study further support the efficacy of single-dose preoperative intraincisional antibiotic treatment for dermatologic surgery. With the relatively high prevalence of patient-reported penicillin allergies, buffered lidocaine containing clindamycin offers an inexpensive, safe, convenient, and effective alternative.

Dr Huether is in private practice in Tucson, Ariz; Dr Griego, in Mesa, Ariz; and Drs Brodland and Zitelli, in Pittsburgh, Pa.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Intraincisional Clindamycin Prophylaxis
Journal Watch Dermatology 2002;2002:3-3.
FULL TEXT