title: 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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Prospective double-blinded placebo-controlled trial testing for difference in infection rates.
  
  
  METHODS
  Primary care in regional North Queensland, Australia.
  
  
  METHODS
  52 patients undergoing lower limb skin lesion excision.
  
  
  METHODS
  2 g dose of cephalexin 30-60 min before excision.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  ACTRN12611000595910.
authors: The Townsville Hospital, Townsville, Queensland, Australia.
authors: Samuel C
authors: SC
authors: Smith
authors: School of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.
authors: Clare F
authors: CF
authors: Heal
authors: School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia.
authors: Petra G
authors: PG
authors: Buttner
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002506:Cephalexin / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011446:Prospective Studies; D011793:Queensland / Q000453:epidemiology; D012878:Skin Neoplasms / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002506:Cephalexin
keywords: antibiotic prophylaxis; dermatological surgery; skin cancer excision; skin lesion excision; surgical site infection