Efficacy of oral antibiotic prophylaxis in prevention of surgical site infection following skin lesion excisions at high risk of infection in general practice

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Certain risk factors are known to be associated with a predictably high rate of surgical wound infection following minor dermatological procedures such as skin lesion excision. The use of oral antibiotic prophylaxis has been suggested as one way of reducing this risk of infection. This project seeks to test the efficacy of such recommendations in the form of a double blind randomised control trial. For the purposes of this trial the high risk group was defined as patients undergoing skin lesion excisions from the lower limb and groin and diabetics having skin lesion excisions from any site. The intervention will consist of a 2g oral dose of cephalexin administered 30-60 minutes prior to the excision while the control will be an identical placebo. Wounds will be assessed for infection using a standardised criteria when patients return for suture removal or earlier if participants re-present due to perceived infection. A wound grading system will also be used and other information which may correlate with infection will also be recorded. This project aims to enrol 100 patients and is a pilot for a large scale multi-centre trial currently in planning.