{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:30:35Z","timestamp":1784035835348,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,13]],"date-time":"2020-05-13T00:00:00Z","timestamp":1589328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The prescribing of postoperative antibiotics for patients undergoing Mohs reconstructive surgery has increased in the last decade, while antibiotic resistance has been increasing. We hypothesized that routine prescribing of postoperative antibiotics after Mohs reconstruction does not decrease the risk of surgical site infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective, single\u2010institution cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study assessed patients who underwent Mohs reconstructive surgery from January 1, 2012, to January 29, 2019. The main outcomes assessed included postoperative surgical site infections, partial or full flap\/graft necrosis, hematoma, and dehiscence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 900 defects in 800 patients (mean age [range] =\u200965.3 [21\u201396], 54.60% female) were identified over the 7\u2010year period. Patient\u2010specific variables reviewed included comorbidities, age, and smoking status. Surgery\u2010specific variables analyzed included defect characteristics, time interval between Mohs micrographic surgery and reconstruction, reconstructive modalities, and use of postoperative antibiotics. All patients received peri\u2010incisional antibiotics. On regression analysis, use of cartilage grafts (odds ratio [OR]: 6.53; 95% CI: 2.1\u201020.6; <jats:italic>P<\/jats:italic> = .001), current smoking status (OR: 6.67; 95% CI: 2.09\u201021.30; <jats:italic>P<\/jats:italic> = .001), full\u2010thickness defects (OR: 1.2; 95% CI: 1.0\u20103.4; <jats:italic>P<\/jats:italic> = .045), and interpolated flap reconstruction (OR: 3.4; 95% CI: 1.0\u201011.5; <jats:italic>P<\/jats:italic> = .049) were associated with an increased risk of postoperative infections. Smoking and cartilage grafting remained significant on bivariable regression modeling. Use of perioperative antibiotics was not associated with a decreased risk of infection (OR: 1.82; 95% CI: 0.23\u201014.21; <jats:italic>P<\/jats:italic> = .568).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no association between postoperative infections after Mohs reconstructive surgery and the use of postoperative antibiotics. These data support a more targeted approach to antibiotic prescribing in Mohs reconstructive surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E434\u2013E439, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28700","type":"journal-article","created":{"date-parts":[[2020,5,13]],"date-time":"2020-05-13T22:05:45Z","timestamp":1589407545000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Do Postoperative Antibiotics Affect Outcomes in Mohs Reconstructive Surgery?"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2470-3897","authenticated-orcid":false,"given":"Matthew Q.","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline S.","family":"Stevens","sequence":"additional","affiliation":[{"name":"School of Medicine University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen S.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Jared","family":"Christophel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,13]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"KauvarA.Mohs: the gold standard. Skin Cancer Foundation website. Available at:https:\/\/www.skincancer.org\/skin-cancer-information\/mohs-surgery\/standard. May 18 2016. Accessed June 21 2019."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2011.08.010"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000000826"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2017.03.002"},{"key":"e_1_2_6_6_1","unstructured":"Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States 2013. Available at:https:\/\/www.cdc.gov\/drugresistance\/pdf\/ar-threats-2013-508.pdf. Accessed May 30 2019."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofv113"},{"key":"e_1_2_6_8_1","unstructured":"Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions\u2014United States 2015. Available at:https:\/\/www.cdc.gov\/antibiotic-use\/community\/programs-measurement\/state-local-activities\/outpatient-antibiotic-prescriptions-US-2015.html. Published October 27 2017. Accessed June 21 2019."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.0152"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001645"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.04.031"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1269"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2006.32167.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.03.042"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.0363"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2017.1154"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2018.1204"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25917"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0904"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1995.tb00255.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.11.032"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2019.0243"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1312691"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1991.01680060086009"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfacial.2011.6"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328355b1f2"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1275773"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.1147"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1996.03890260063009"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.pan.a004868"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk052"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-9-56"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000191181.73298.b3"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215107007529"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X14545984"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020213"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.28700","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28700","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.28700","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.28700","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T08:02:37Z","timestamp":1693641757000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.28700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,13]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1002\/lary.28700"],"URL":"https:\/\/doi.org\/10.1002\/lary.28700","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,13]]},"assertion":[{"value":"2019-11-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}