Dispelling myths in dermatologic surgery.

Several common practices and widely accepted principles implemented in dermatologic surgery are based on perpetuated beliefs not supported by evidence-based medicine. After evaluating the validity of misconceptions in dermatologic surgery, updated recommendations include restriction of antibiotic prophylaxis to patient-specific risk factors, continuation of anticoagulant therapy perioperatively, safe use of epinephrine for digital anesthesia, clean technique as an efficacious substitute for sterile, topical emollients and petroleum instead of antimicrobials to prevent surgical site infection, alternatives to elliptical excisions for decreasing scar length, wound eversion for areas of greater cosmetic concern, and cessation of systemic retinoids as an unnecessary prerequisite for most cutaneous procedures. Surgical procedures in dermatology are not as conducive to extensive validation studies, leading to the propagation of myths based on anecdotal evidence. Although current reports in the literature discredit several misconceptions, well-designed and adequately powered randomized studies are needed to verify optimal procedural guidelines.