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

Smith, Samuel C., Heal, Clare F., and Buttner, Petra G. (2014) 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. BMJ Open, 4 (7). e005270. pp. 1-8.

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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.

Item ID: 35408
Item Type: Article (Research - C1)
ISSN: 2044-6055
Keywords: randomised controlled trial; surgical site infection; lower limb; skin excision; antibiotic prophylaxis
Additional Information:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Funders: James Cook University (JCU), Primary Health Care Research and Information Service
Date Deposited: 24 Sep 2014 00:18
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111716 Preventive Medicine @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920117 Skin and Related Disorders @ 100%
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