Intranasal Povidone Iodine Swab Versus Oral Antibiotic Prophylaxis for the Prevention of Surgical Site Infection in Patients Undergoing Mohs Micrographic Surgery for Skin Cancers

Inclusion Criteria

• 18 years or older
• Non-pregnant
• Non-lactating/breastfeeding
• Non-incarcerated
• English-speaking persons undergoing MMS for malignant cutaneous neoplasms and receiving same-day defect repair by the MMS-performing surgeon
• Patients must be able to provide written informed consent prior to initiation of any study-specific procedures
• Patients must be able to swallow, retain, and absorb oral medications
• All malignant cutaneous neoplasms will be included

Exclusion Criteria

• Patients on antibiotic treatment or established intolerance or contraindication to povidone-iodine
• Patients with an allergy to specific oral antibiotics that are utilized as part of the Mayo Clinic antibiotic prophylaxis protocol will be excluded (cefalexin, azithromycin, clindamycin)
• Patients requiring oral antibiotic therapy for prophylaxis postoperative infectious endocarditis or hematogenous total joint infection will also be excluded
• Cases where skin reconstruction is performed with non-sterile gloves will also be excluded
• We will also exclude patients with lesions on the legs as dilute vinegar soaks are standard practice and this would be a confounder for preventing surgical site infection
• Patients at increased risk for severe infections, including patients on immunosuppressive medications and biologics, patients with a history of HIV infection, chronic lymphocytic leukemia, immunodeficiency syndromes, as well as patients with insulin-dependent diabetes mellitus, will be excluded