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Randomized Controlled Trial
. 2014 Jul 30;4(7):e005270.
doi: 10.1136/bmjopen-2014-005270.

Prevention of surgical site infection in lower limb skin lesion excisions with single dose oral antibiotic prophylaxis: a prospective randomised placebo-controlled double-blind trial

Samuel C Smith  1 , Clare F Heal  2 , Petra G Buttner  3
Affiliations
Randomized Controlled Trial

Prevention of surgical site infection in lower limb skin lesion excisions with single dose oral antibiotic prophylaxis: a prospective randomised placebo-controlled double-blind trial

Samuel C Smith et al. BMJ Open. .

Abstract

Objectives: To determine the effectiveness of a single perioperative prophylactic 2 g dose of cephalexin in preventing surgical site infection (SSI) following excision of skin lesions from the lower limb.

Design: Prospective double-blinded placebo-controlled trial testing for difference in infection rates.

Setting: Primary care in regional North Queensland, Australia.

Participants: 52 patients undergoing lower limb skin lesion excision.

Interventions: 2 g dose of cephalexin 30-60 min before excision.

Main outcome measures: Incidence of SSI.

Results: Incidence of SSI was 12.5% (95% CI 2.7% to 32.4%) in the cephalexin group compared with 35.7% (95% CI 18.6% to 55.9%) in the placebo group (p=0.064). This represented an absolute reduction of 23.21% (95% CI -0.39% to 46.82%), relative reduction of 65.00% (95% CI -12.70% to 89.13%) and number-needed-to-treat of 4.3.

Conclusions: Administration of a single 2 g dose of cephalexin 30-60 min before skin lesion excision from the lower limb may produce a reduction in the incidence of infection; however, this study was underpowered to statistically determine this.

Trial registration number: ACTRN12611000595910.

Keywords: antibiotic prophylaxis; dermatological surgery; skin cancer excision; skin lesion excision; surgical site infection.

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Figures

Figure 1
Figure 1
Trial profile (ROS, removal of sutures).
See this image and copyright information in PMC

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