title: Heightened infection-control practices are associated with significantly lower infection rates in office-based Mohs surgery.
abstract: BACKGROUND
  Reported infection rates for Mohs micrographic surgery (MMS) range from less than 1% to 3.5%.
  
  
  OBJECTIVE
  To determine whether lower infection rates are possible for MMS with a consistently applied infection-control regimen.
  
  
  METHODS
  A series of 832 consecutive patients with 950 tumors undergoing MMS formed the cohort for a retrospective study of infections before and after a program of heightened infection-control practices at a single-surgeon academic Mohs practice. The sterility upgrade included jewelry restrictions, alcohol hand scrub before stages and reconstruction, sterile gloves and (during reconstruction) sterile gowns for staff, and sterile towels and dressings for patients during Mohs stages.
  
  
  RESULTS
  Infection rate was 2.5% (9 infections/365 tumors) before the sterility upgrade and 0.9% (5 infections/585 tumors) after, a statistically significant difference (p=.04).
  
  
  CONCLUSIONS
  MMS already has low rates of infection, but this study shows that rigorous infection-control practices can significantly affect infection rates. The authors have indicated no significant interest with commercial supporters.
authors.affiliation: Department of Dermatology, University of Texas Medical Branch, Galveston, Texas, USA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Martin
authors.forename: Lark-Aeryn
authors.initials: LA
authors.lastname: Speyer
authors.forename: Chrysalyne D
authors.initials: CD
authors.lastname: Schmults
mesh_terms: D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000009:adverse effects / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D013242:Sterilization / Q000379:methods / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology