{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:20:12Z","timestamp":1786972812470,"version":"build-2736575974"},"reference-count":29,"publisher":"BMJ","issue":"4","funder":[{"name":"The Skin Cancer College of Australasia"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,2,14]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is limited published research studying the effect of antibiotic prophylaxis on surgical site infection (SSI) in dermatological surgery, and there is no consensus for its use in higher-risk cases. The objective of this study was to determine the effectiveness of a single oral preoperative 2\u2009g dose of cephalexin in preventing SSI following flap and graft dermatological closures on the nose and ear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective double-blinded, randomised, placebo-controlled trial testing for difference in infection rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Primary care skin cancer clinics in North Queensland, Australia, were randomised to 2\u2009g oral cephalexin or placebo 40\u201360\u2009min prior to skin incision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>154 consecutive eligible patients booked for flap or graft closure following skin cancer excision on the ear and nose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>2\u2009g dose of cephalexin administered 40\u201360\u2009min prior to surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall 8\/69 (11.6%) controls and 1\/73 (1.4%) in the intervention group developed SSI (p=0.015; absolute SSI reduction 10.2%; number needed to treat (NNT) for benefit 9.8, 95%\u2009CI 5.5 to 45.5). In males, 7\/44 controls and 0\/33 in the intervention group developed SSI (p=0.018; absolute SSI reduction 15.9%; NNT for benefit 6.3, 95%\u2009CI 3.8 to 19.2). SSI was much lower in female controls (1\/25) and antibiotic prophylaxis did not further reduce this (p=1.0). There was no difference between the study groups in adverse symptoms attributable to high-dose antibiotic administration (p=0.871).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A single oral 2\u2009g dose of cephalexin given before complex skin closure on the nose and ear reduced SSI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ANZCTR 365115; Post-results.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020213","type":"journal-article","created":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T07:30:38Z","timestamp":1524123038000},"page":"e020213","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Effect of a single prophylactic preoperative oral antibiotic dose on surgical site infection following complex dermatological procedures on the nose and ear: a prospective, randomised, controlled, double-blinded trial"],"prefix":"10.1136","volume":"8","author":[{"given":"Helena","family":"Rosengren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare F","family":"Heal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra G","family":"Buttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,19]]},"reference":[{"key":"2024051711322357000_8.4.e020213.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2005.31014"},{"key":"2024051711322357000_8.4.e020213.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.04.031"},{"key":"2024051711322357000_8.4.e020213.3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s13671-012-0012-z","article-title":"An Update on Antibiotic Prophylaxis in Dermatologic Surgery","volume":"1","author":"Rosengren","year":"2012","journal-title":"Curr Dermatol Rep"},{"key":"2024051711322357000_8.4.e020213.4","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1053\/sd.2000.7372","article-title":"Antimicrobial prophylaxis in dermatology","volume":"19","author":"Hirschmann","year":"2000","journal-title":"Semin Cutan Med Surg"},{"key":"2024051711322357000_8.4.e020213.5","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/15.4.502"},{"key":"2024051711322357000_8.4.e020213.6","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.jaad.2005.04.089","article-title":"Basal cell carcinoma treated with Mohs surgery in Australia III. 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