CO2 Laser Skin Resurfacing Prophylaxis

Abstract

Large raw exposed facial areas following resurfacing may invite devastating bacterial cellulitis (Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa), primary herpes simplex, or reactivation of latent herpes simplex with disseminated facial scarring. To achieve therapeutic levels at the time of treatment, physicians may prescribe prophylactic antibiotic and antiviral medications prior to surgery (Table 135.1). Medications are continued for 12 days or until reepithelialization is well established. All resurfacing patients, except those undergoing very small treatment areas, receive a preoperative oral antibiotic, usually ciprofloxacin hydrochloride (Cipro®) 500 mg orally B.I.D. for 14 days, beginning 48 hours prior to surgery. Acyclovir (Zovirax®), a thymidine kinase inhibitor that is active against human herpesviruses, may be prescribed as 400 mg orally every 8 hours for 14 days, begun at least 2 days prior to surgery.Table 135.1Resurfacing Prophylactic Preoperative Care