Conflict of interest: none declared.
A guide to anticoagulation and endocarditis prophylaxis during cutaneous surgery
Article first published online: 21 DEC 2009
© 2009 The Author(s). Journal compilation © 2009 British Association of Dermatologists
Clinical and Experimental Dermatology
Volume 35, Issue 8, pages 817–822, December 2010
How to Cite
Child, N., Anjum, N., Keohane, S. G. and Cooper, H. L. (2010), A guide to anticoagulation and endocarditis prophylaxis during cutaneous surgery. Clinical and Experimental Dermatology, 35: 817–822. doi: 10.1111/j.1365-2230.2009.03750.x
- Issue published online: 4 NOV 2010
- Article first published online: 21 DEC 2009
- Accepted for publication 19 September 2009
Summary Management of perioperative antiplatelet/anticoagulation drugs and appropriate antibiotic prophylaxis for endocarditis are two controversial issues in the safe practice of cutaneous surgery. This article highlights the current best practice based on a literature review on these topics. Antiplatelet agents should be continued perioperatively whenever clinically possible, and discontinued only after consultation with the patient’s cardiologist. The exception to this is primary cardiovascular disease, when antiplatelet drugs should be stopped for 1 week before surgery. Warfarin can be continued perioperatively when the international normalised ratio is controlled at < 3. The use of antibiotics in patients at risk of endocarditis has been recently reviewed by the National Institute of Health and Clinical Excellence (NICE), the American Heart Association, and the European Society of Cardiology. The advice has changed significantly over the past few years, and the routine use of antibiotics perioperatively should occur only when there is evidence of infection perioperatively at the site of surgery.