Use of perioperative prophylactic antibiotics following excision of ulcerated skin lesions in the UK: a national, multispeciality survey of clinicians
Summary Skin cancer is the most common malignancy in the UK, and up to a third of lesions are ulcerated at the time of excision. Ulceration has been shown to increase the risk of developing surgical site infection following excision, with some studies finding infection rates of 33%. However, no spec...
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| Veröffentlicht in: | Clinical and experimental dermatology 2022-05, Vol.47 (5), p.957-959 |
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| container_title | Clinical and experimental dermatology |
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| creator | Totty, Joshua Philip Matin, Rubeta N. Wernham, Aaron Ray, Ruby Thomas‐Jones, Emma Abbott, Rachel Angharad |
| description | Summary
Skin cancer is the most common malignancy in the UK, and up to a third of lesions are ulcerated at the time of excision. Ulceration has been shown to increase the risk of developing surgical site infection following excision, with some studies finding infection rates of 33%. However, no specific guidelines for the use of antibiotic prophylaxis in such cases exist. We surveyed 129 clinicians (covering Dermatology, Plastic Surgery, Ear, Nose and Throat Surgery, and Oral and Maxillofacial Surgery) who all excise skin lesions on a regular basis. There was significant variability in their practice with regard to antibiotic prophylaxis, with 9% always prescribing them and 19% never prescribing them. Variation exists both among and between specialities. This variation increases the risk of antimicrobial resistance and shows a paucity of good clinical evidence, indicating that a well‐designed clinical trial is needed to guide future practice. |
| doi_str_mv | 10.1111/ced.15075 |
| format | Article |
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Skin cancer is the most common malignancy in the UK, and up to a third of lesions are ulcerated at the time of excision. Ulceration has been shown to increase the risk of developing surgical site infection following excision, with some studies finding infection rates of 33%. However, no specific guidelines for the use of antibiotic prophylaxis in such cases exist. We surveyed 129 clinicians (covering Dermatology, Plastic Surgery, Ear, Nose and Throat Surgery, and Oral and Maxillofacial Surgery) who all excise skin lesions on a regular basis. There was significant variability in their practice with regard to antibiotic prophylaxis, with 9% always prescribing them and 19% never prescribing them. Variation exists both among and between specialities. This variation increases the risk of antimicrobial resistance and shows a paucity of good clinical evidence, indicating that a well‐designed clinical trial is needed to guide future practice.</description><identifier>ISSN: 0307-6938</identifier><identifier>EISSN: 1365-2230</identifier><identifier>DOI: 10.1111/ced.15075</identifier><identifier>PMID: 34939216</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Antibiotic Prophylaxis ; Antibiotics ; Antimicrobial resistance ; Disease prevention ; Humans ; Malignancy ; Maxillofacial ; Prophylaxis ; Reconstructive Surgical Procedures ; Skin cancer ; Skin diseases ; Skin Diseases - drug therapy ; Skin lesions ; Surgery ; Surgical site infections ; Surgical Wound Infection - drug therapy ; Surgical Wound Infection - prevention & control ; United Kingdom</subject><ispartof>Clinical and experimental dermatology, 2022-05, Vol.47 (5), p.957-959</ispartof><rights>2021 British Association of Dermatologists</rights><rights>2021 British Association of Dermatologists.</rights><rights>Copyright © 2022 British Association of Dermatologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3485-df55e6a38706bb75e4ea41668b311244f71c0c96f44aeab061df3e991354e9c13</cites><orcidid>0000-0002-9695-5412 ; 0000-0002-0063-1414 ; 0000-0001-5920-6888 ; 0000-0002-3415-7132</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34939216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Totty, Joshua Philip</creatorcontrib><creatorcontrib>Matin, Rubeta N.</creatorcontrib><creatorcontrib>Wernham, Aaron</creatorcontrib><creatorcontrib>Ray, Ruby</creatorcontrib><creatorcontrib>Thomas‐Jones, Emma</creatorcontrib><creatorcontrib>Abbott, Rachel Angharad</creatorcontrib><title>Use of perioperative prophylactic antibiotics following excision of ulcerated skin lesions in the UK: a national, multispeciality survey of clinicians</title><title>Clinical and experimental dermatology</title><addtitle>Clin Exp Dermatol</addtitle><description>Summary
Skin cancer is the most common malignancy in the UK, and up to a third of lesions are ulcerated at the time of excision. Ulceration has been shown to increase the risk of developing surgical site infection following excision, with some studies finding infection rates of 33%. However, no specific guidelines for the use of antibiotic prophylaxis in such cases exist. We surveyed 129 clinicians (covering Dermatology, Plastic Surgery, Ear, Nose and Throat Surgery, and Oral and Maxillofacial Surgery) who all excise skin lesions on a regular basis. There was significant variability in their practice with regard to antibiotic prophylaxis, with 9% always prescribing them and 19% never prescribing them. Variation exists both among and between specialities. This variation increases the risk of antimicrobial resistance and shows a paucity of good clinical evidence, indicating that a well‐designed clinical trial is needed to guide future practice.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotic Prophylaxis</subject><subject>Antibiotics</subject><subject>Antimicrobial resistance</subject><subject>Disease prevention</subject><subject>Humans</subject><subject>Malignancy</subject><subject>Maxillofacial</subject><subject>Prophylaxis</subject><subject>Reconstructive Surgical Procedures</subject><subject>Skin cancer</subject><subject>Skin diseases</subject><subject>Skin Diseases - drug therapy</subject><subject>Skin lesions</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - drug therapy</subject><subject>Surgical Wound Infection - prevention & control</subject><subject>United Kingdom</subject><issn>0307-6938</issn><issn>1365-2230</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1P3DAQhq2qCJaPQ_8AssSlSATs-COb3qotFAQSF_YcOd4JDPXaaZwA-SP8XpwuXJDqgz0aP_NIo5eQb5yd8nTOLKxOuWKF-kJmXGiV5blgX8mMCVZkuhTzHbIb4yNjXPBCbZMdIUtR5lzPyOsyAg0NbaHDkC7T4xPQtgvtw-iM7dFS43usMaQy0iY4F57R31N4sRgx-Gl4cHaahBWNf9BTB9NHpKnsH4Aur39QQ30yB2_cCV0PrsfYgkXjsB9pHLonGCePdegxtX3cJ1uNcREO3t89srw4v1tcZje3v68WP28yK-RcZatGKdBGzAum67pQIMFIrvW8FpznUjYFt8yWupHSgKmZ5qtGQFlyoSSUlos98n3jTRv_HSD21RqjBeeMhzDEKtdc5GWumEro0Sf0MQxd2miilJRM5YVO1PGGsl2IsYOmajtcm26sOKumsKoUVvUvrMQevhuHep26H-RHOgk42wDP6GD8v6lanP_aKN8A3jSgLA</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Totty, Joshua Philip</creator><creator>Matin, Rubeta N.</creator><creator>Wernham, Aaron</creator><creator>Ray, Ruby</creator><creator>Thomas‐Jones, Emma</creator><creator>Abbott, Rachel Angharad</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9695-5412</orcidid><orcidid>https://orcid.org/0000-0002-0063-1414</orcidid><orcidid>https://orcid.org/0000-0001-5920-6888</orcidid><orcidid>https://orcid.org/0000-0002-3415-7132</orcidid></search><sort><creationdate>202205</creationdate><title>Use of perioperative prophylactic antibiotics following excision of ulcerated skin lesions in the UK: a national, multispeciality survey of clinicians</title><author>Totty, Joshua Philip ; Matin, Rubeta N. ; Wernham, Aaron ; Ray, Ruby ; Thomas‐Jones, Emma ; Abbott, Rachel Angharad</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3485-df55e6a38706bb75e4ea41668b311244f71c0c96f44aeab061df3e991354e9c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotic Prophylaxis</topic><topic>Antibiotics</topic><topic>Antimicrobial resistance</topic><topic>Disease prevention</topic><topic>Humans</topic><topic>Malignancy</topic><topic>Maxillofacial</topic><topic>Prophylaxis</topic><topic>Reconstructive Surgical Procedures</topic><topic>Skin cancer</topic><topic>Skin diseases</topic><topic>Skin Diseases - drug therapy</topic><topic>Skin lesions</topic><topic>Surgery</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - drug therapy</topic><topic>Surgical Wound Infection - prevention & control</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Totty, Joshua Philip</creatorcontrib><creatorcontrib>Matin, Rubeta N.</creatorcontrib><creatorcontrib>Wernham, Aaron</creatorcontrib><creatorcontrib>Ray, Ruby</creatorcontrib><creatorcontrib>Thomas‐Jones, Emma</creatorcontrib><creatorcontrib>Abbott, Rachel Angharad</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Totty, Joshua Philip</au><au>Matin, Rubeta N.</au><au>Wernham, Aaron</au><au>Ray, Ruby</au><au>Thomas‐Jones, Emma</au><au>Abbott, Rachel Angharad</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of perioperative prophylactic antibiotics following excision of ulcerated skin lesions in the UK: a national, multispeciality survey of clinicians</atitle><jtitle>Clinical and experimental dermatology</jtitle><addtitle>Clin Exp Dermatol</addtitle><date>2022-05</date><risdate>2022</risdate><volume>47</volume><issue>5</issue><spage>957</spage><epage>959</epage><pages>957-959</pages><issn>0307-6938</issn><eissn>1365-2230</eissn><abstract>Summary
Skin cancer is the most common malignancy in the UK, and up to a third of lesions are ulcerated at the time of excision. Ulceration has been shown to increase the risk of developing surgical site infection following excision, with some studies finding infection rates of 33%. However, no specific guidelines for the use of antibiotic prophylaxis in such cases exist. We surveyed 129 clinicians (covering Dermatology, Plastic Surgery, Ear, Nose and Throat Surgery, and Oral and Maxillofacial Surgery) who all excise skin lesions on a regular basis. There was significant variability in their practice with regard to antibiotic prophylaxis, with 9% always prescribing them and 19% never prescribing them. Variation exists both among and between specialities. This variation increases the risk of antimicrobial resistance and shows a paucity of good clinical evidence, indicating that a well‐designed clinical trial is needed to guide future practice.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>34939216</pmid><doi>10.1111/ced.15075</doi><tpages>959</tpages><orcidid>https://orcid.org/0000-0002-9695-5412</orcidid><orcidid>https://orcid.org/0000-0002-0063-1414</orcidid><orcidid>https://orcid.org/0000-0001-5920-6888</orcidid><orcidid>https://orcid.org/0000-0002-3415-7132</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical and experimental dermatology, 2022-05, Vol.47 (5), p.957-959 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Anti-Bacterial Agents - therapeutic use Antibiotic Prophylaxis Antibiotics Antimicrobial resistance Disease prevention Humans Malignancy Maxillofacial Prophylaxis Reconstructive Surgical Procedures Skin cancer Skin diseases Skin Diseases - drug therapy Skin lesions Surgery Surgical site infections Surgical Wound Infection - drug therapy Surgical Wound Infection - prevention & control United Kingdom |
| title | Use of perioperative prophylactic antibiotics following excision of ulcerated skin lesions in the UK: a national, multispeciality survey of clinicians |
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