In the July issue of the ARCHIVES, Haas and Grekin1 commended our recently published study on intraincisional prophylactic antibiotics,2 but expressed their concerns about several issues. Their letter addresses several points that warrant clarification. First, we would like to clarify the timing of the administration of the prophylactic antibiotics. In our study, the lidocaine hydrochloride solution containing nafcillin was administered in a manner identical to the method that we routinely use for administering all local anesthesia prior to reconstruction. Specifically, the local anesthetic solution is injected into the subcutaneous tissues and allowed to anesthetize the area and induce vasoconstriction over a period of approximately 15 minutes. Immediately after anesthesia occurs, reconstruction is begun. The time lag after the injection of the antibiotic and lidocaine solution is not intended to enhance the effects of the antibiotic.
Griego RD, Zitelli JA. Antibiotic Prophylaxis. Arch Dermatol. 1999;135(6):716-717. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-6-dlt0699