Maragh Sherry L, Otley Clark C, Roenigk Randall K, Phillips P Kim
Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Dermatol Surg. 2005 Jan;31(1):83-91. doi: 10.1111/j.1524-4725.2005.31014.
Antibiotic prophylaxis in dermatologic surgery is poorly understood, and data on its use are lacking. Prophylaxis is indicated for the prevention of endocarditis and prosthesis infection, as well as surgical site infection.
We review essential considerations for the use of antibiotic prophylaxis in dermatologic surgery and provide clear guidelines for practical implementation.
Guidelines were developed after review of the literature and consultation with infectious disease specialists and subspecialists in the areas of cardiac, orthopedic, and neurosurgical infectious disease at Mayo Clinic.
Three factors affect the decision to use prophylactic antibiotics in dermatologic surgery: (1) the underlying indication for prophylaxis (patient risk stratification), (2) the condition of the skin, and (3) the specific procedure planned. Thorough preoperative evaluation and surgical planning are critical in identifying and optimizing patient and environmental risk factors that may increase the risk of infection. Appropriate antibiotic selections with site-specific consideration and appropriate timing of antibiotic administration are key factors in providing effective prophylaxis.
Low rates of infection associated with dermatologic surgical procedures warrant selective use of antibiotic prophylaxis. The proposed guidelines reflect current standards of practice.
皮肤科手术中的抗生素预防措施尚未得到充分理解，且缺乏相关使用数据。预防措施适用于预防心内膜炎和假体感染以及手术部位感染。
我们回顾了皮肤科手术中使用抗生素预防的重要考虑因素，并为实际应用提供明确的指导方针。
在查阅文献并咨询梅奥诊所心脏、骨科和神经外科传染病领域的传染病专家及亚专科专家后制定了指南。
有三个因素影响皮肤科手术中使用预防性抗生素的决策：（1）预防的潜在指征（患者风险分层），（2）皮肤状况，以及（3）计划的具体手术。术前进行全面评估和手术规划对于识别和优化可能增加感染风险的患者及环境风险因素至关重要。选择合适的抗生素并考虑特定部位，以及在合适的时间给予抗生素是提供有效预防的关键因素。
皮肤科手术相关感染率较低，因此有必要选择性地使用抗生素预防。所提出的指南反映了当前的实践标准。
