Antimicrobial prophylaxis in dermatologic surgery.

Antimicrobial prophylaxis is rarely appropriate for dermatologic surgery. Dermatologic procedures seldom cause bacteremia, and they have been implicated as a cause in only an extremely small number of cases of endocarditis or infections of vascular grafts or orthopedic prostheses. Accordingly, systemic prophylactic antibiotics are not indicated in patients undergoing dermatologic surgery who have valvular heart disease, vascular grafts, or orthopedic prostheses. Because wound infections following dermatologic surgery are uncommon, usually mild, and generally easily treatable, systemic antimicrobial prophylaxis is not indicated to prevent postoperative wound infections either. Topical antibiotic ointments for that purpose are ineffective. Whether prophylactic antivirals are helpful in preventing herpes simplex infections after facial resurfacing is uncertain.