Pre-incision Skin Preparation

This is of critical importance, ensuring not only that the antibacterial solution used has broad-spectrum properties but also that the product is properly applied to avoid oral contamination of the surgical incision sites. Additional strategies used to reduce bacterial migration into the surgical incision include the use of antiseptic impregnated adhesive drapes and/or novel cyanoacrylate-based skin sealants that can be applied over the skin preparation site to immobilize residual skin flora, including those imbedded in hair follicles [31].

Intraoperative Considerations

Incisions

The incisions for access to the surgical site must be large enough to expeditiously execute the procedure. Small incisions, though potentially less conspicuous, may require more forceful retraction, requiring excessive traction on the wound skin edges, resulting in ischemia. This can lead to poor healing, increasing the potential for infection, or excessive scarring. Precise wound closure is an important to assure proper healing, thereby decreasing the incidence of infection [30].