The development of wound infection in dermatologic surgery is influenced by a number of factors, some of which may act in combination. Several of these well-known factors include the anatomical location of the wound, remote presence of skin infection, the characteristics of the lesion (eg, inflamed vs noninflamed), variable practice of aseptic technique, surgical technique (eg, development of hematomas, poorly designed closure under tension, etc), and the overall protoplasm of the patient (nutritional status, immunologic status, etc). The degree to which the administration of antibiotic prophylaxis mitigates the development of wound infection (or endocarditis prophylaxis) is clearly not conclusive and continues to be controversial. However, the overwhelming opinion expressed in the medical literature (which parallels discussions in the lay press) is that the medical community continues to overadminister antibiotics.
Haas AF, Grekin RC. Practical Thoughts on Antibiotic Prophylaxis. Arch Dermatol. 1998;134(7):872-873. doi: