H. Smith, C. Vinciullo, P. Cherian, Y. Tai, K. Borchard
Surgical site infection (SSI) is the commonest complication following surgery. Improved operating standards have reduced the rate at which exogenous bacteria cause SSI. The majority of SSI are now caused by the patient’s endogenous bacteria. Staphylococcus aureus is the commonest pathogen for dermatologic surgery. The prescription of antibiotics to patients likely to be at higher risk of infection following dermatologic surgery has been standard practice. The evidence for accurate assignment of risk for this intervention is questionable. There is little evidence to support stat doses of oral antibiotics at the time of surgery and evidence that they have no effect for dermatologic surgery. Recent research has shown that nasal carriage of staphylococcus aureus is highly predictive of SSI risk in dermatologic surgery. Topical decolonisation prior to surgery has been shown to decrease this risk more effectively than oral antibiotics. Recent research which will be presented showing a trend that patients without a positive nasal swab can beneﬁt from decolonisation. This would allow an argument to be made for moving away from screen and treat to universal decolonisation.