Dr Marc D. Brown’s presentation provided a detailed overview of recent studies shaping dermatologic surgery practices published in Dermatologic Surgery. One key topic addressed in the journal is the low incidence of bacteremia, infective endocarditis, and prosthetic joint infections in dermatologic surgery. Based on a systematic review, the findings suggest that prophylactic antibiotics may not be necessary for most cutaneous surgeries, as the risk of complications is minimal. Another study presented addressed the effect of preoperative chlorhexidine gluconate cleansing on reducing surgical site infections, particularly for lower extremity surgeries. In one retrospective cohort study, daily chlorhexidine washes for 14 days significantly reduced infection rates to 0% in Mohs surgeries. 

Brown discussed the use of novel oral anticoagulants (NOACs) in dermatologic surgery, which have become increasingly common. A study found that NOAC monotherapy does not lead to a significant increase in postoperative bleeding complications compared to patients not on antithrombotics. However, combining NOACs with aspirin greatly increased bleeding risk, highlighting the need for careful management of anticoagulated patients. 

The presentation also examined the off-label use of topical treatments like 5-fluorouracil (5-FU) and imiquimod for squamous cell carcinoma (SCC) in situ. While 5-FU was effective for smaller lesions, recurrence rates were higher for larger ones. Imaging techniques, such as MRI, CT, and PET scans, were highlighted for their effectiveness in detecting high-risk tumor features, such as perineural invasion and bone involvement, especially in SCC cases. 

Lastly, Dr Brown highlighted findings from Dermatologic Surgery showing that intraoperative immunohistochemistry during Mohs surgery significantly reduces local recurrence rates in invasive melanoma, making it a valuable tool for improving surgical outcomes.