{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:03:08Z","timestamp":1791932588656,"version":"4.3.4"},"reference-count":42,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jshoulderelbow.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Shoulder and Elbow Surgery"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.jse.2025.08.008","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T01:22:36Z","timestamp":1758590556000},"page":"956-964","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of pretreatment of the pilosebaceous unit on Cutibacterium acnes burden during shoulder arthroplasty: a randomized controlled trial"],"prefix":"10.1016","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3410-9288","authenticated-orcid":false,"given":"Ian D.","family":"Hutchinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6021-3273","authenticated-orcid":false,"given":"Andrew D.","family":"Posner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5743-2670","authenticated-orcid":false,"given":"Joshua I.","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Zanaros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Dines","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua S.","family":"Dines","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel A.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Zimmerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence V.","family":"Gulotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jse.2025.08.008_bib1","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1007\/s10103-017-2317-4","article-title":"Effect of wavelength and beam width on penetration in light-tissue interaction using computational methods","volume":"32","author":"Ash","year":"2017","journal-title":"Lasers Med Sci"},{"key":"10.1016\/j.jse.2025.08.008_bib2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1574-695X.2003.tb00644.x","article-title":"Eradication of Propionibacterium acnes by its endogenic porphyrins after illumination with high intensity blue light","volume":"35","author":"Ashkenazi","year":"2003","journal-title":"FEMS Immunol Med Microbiol"},{"key":"10.1016\/j.jse.2025.08.008_bib3","article-title":"Shoulder periprosthetic joint infection and all-cause mortality: a worrisome association","volume":"7","author":"Austin","year":"2022","journal-title":"JB JS Open Access"},{"key":"10.1016\/j.jse.2025.08.008_bib4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.36849\/JDD.7150","article-title":"Sixty years of benzoyl peroxide use in dermatology","volume":"22","author":"Baldwin","year":"2023","journal-title":"J Drugs Dermatol"},{"key":"10.1016\/j.jse.2025.08.008_bib5","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1016\/j.jse.2020.08.010","article-title":"Increasing incidence of primary reverse and anatomic total shoulder arthroplasty in the United States","volume":"30","author":"Best","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib6","doi-asserted-by":"crossref","first-page":"187","DOI":"10.7150\/jbji.46199","article-title":"Effect of blue light and photosensitizers on Cutibacterium acnes on shoulder periprosthetic joint infection isolates","volume":"5","author":"Bhargava","year":"2020","journal-title":"J Bone Jt Infect"},{"key":"10.1016\/j.jse.2025.08.008_bib7","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/s13555-016-0138-1","article-title":"Optimizing non-antibiotic treatments for patients with acne: a review","volume":"6","author":"Canavan","year":"2016","journal-title":"Dermatol Ther (Heidelb)"},{"key":"10.1016\/j.jse.2025.08.008_bib8","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1016\/j.jse.2019.03.038","article-title":"Hydrogen peroxide skin preparation reduces Cutibacterium acnes in shoulder arthroplasty: a prospective, blinded, controlled trial","volume":"28","author":"Chalmers","year":"2019","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib9","doi-asserted-by":"crossref","DOI":"10.1016\/j.bioflm.2021.100063","article-title":"The role of biofilm formation in the pathogenesis and antimicrobial susceptibility of Cutibacterium acnes","volume":"4","author":"Coenye","year":"2022","journal-title":"Biofilm"},{"key":"10.1016\/j.jse.2025.08.008_bib10","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1016\/j.jse.2021.08.008","article-title":"Efficacy of combinational therapy using blue light and benzoyl peroxide in reducing Cutibacterium acnes bioburden at the deltopectoral interval: a randomized controlled trial","volume":"30","author":"Cotter","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib11","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.drup.2012.07.001","article-title":"Blue light for infectious diseases: propionibacterium acnes, Helicobacter pylori, and beyond?","volume":"15","author":"Dai","year":"2012","journal-title":"Drug Resist Updat"},{"key":"10.1016\/j.jse.2025.08.008_bib12","doi-asserted-by":"crossref","DOI":"10.3390\/s21206943","article-title":"Effect of blue light on acne vulgaris: a systematic review","volume":"21","author":"Diogo","year":"2021","journal-title":"Sensors (Basel)"},{"key":"10.1016\/j.jse.2025.08.008_bib13","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1016\/j.jse.2017.03.003","article-title":"Benzoyl peroxide and clindamycin topical skin preparation decreases Propionibacterium acnes colonization in shoulder arthroscopy","volume":"26","author":"Dizay","year":"2017","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib14","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.jse.2019.06.026","article-title":"Benzoyl peroxide use transiently decreases Cutibacterium acnes load on the shoulder","volume":"29","author":"Duvall","year":"2020","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib15","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.2106\/JBJS.15.01133","article-title":"Contamination of the surgical field with Propionibacterium acnes in primary shoulder arthroplasty","volume":"98","author":"Falconer","year":"2016","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2025.08.008_bib16","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.jse.2012.07.017","article-title":"Clinical meaning of unexpected positive cultures (UPC) in revision shoulder arthroplasty","volume":"22","author":"Foruria","year":"2013","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib17","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.2106\/JBJS.N.00881","article-title":"Early versus late culture growth of Propionibacterium acnes in revision shoulder arthroplasty","volume":"97","author":"Frangiamore","year":"2015","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2025.08.008_bib18","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jse.2022.07.019","article-title":"Preoperative topical benzoyl peroxide treatment is effective in reducing Cutibacterium acnes in shoulder surgery: a systematic review","volume":"32","author":"Green","year":"2023","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib19","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1016\/j.jid.2021.11.029","article-title":"Aging-associated changes in the adult human skin microbiome and the host factors that affect skin microbiome composition","volume":"142","author":"Howard","year":"2022","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.jse.2025.08.008_bib20","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s00264-020-04594-x","article-title":"Randomized controlled trial of chlorhexidine wash versus benzoyl peroxide soap for home surgical preparation: neither is effective in removing cutibacterium from the skin of shoulder arthroplasty patients","volume":"44","author":"Hsu","year":"2020","journal-title":"Int Orthop"},{"key":"10.1016\/j.jse.2025.08.008_bib21","first-page":"151","article-title":"Incidence of Cutibacterium acnes in open shoulder surgery","volume":"83","author":"Kajita","year":"2021","journal-title":"Nagoya J Med Sci"},{"key":"10.1016\/j.jse.2025.08.008_bib22","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.jseint.2020.04.020","article-title":"Risk factors for increased shoulder Cutibacterium acnes burden","volume":"4","author":"Kaveeshwar","year":"2020","journal-title":"JSES Int"},{"key":"10.1016\/j.jse.2025.08.008_bib23","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0923-1811(02)00068-3","article-title":"Acne phototherapy with a high-intensity, enhanced, narrow-band, blue light source: an open study and in vitro investigation","volume":"30","author":"Kawada","year":"2002","journal-title":"J Dermatol Sci"},{"key":"10.1016\/j.jse.2025.08.008_bib24","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1016\/j.jse.2018.06.012","article-title":"Neer award 2018: benzoyl peroxide effectively decreases preoperative Cutibacterium acnes shoulder burden: a prospective randomized controlled trial","volume":"27","author":"Kolakowski","year":"2018","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib25","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.2106\/JBJS.M.01474","article-title":"Propionibacterium persists in the skin despite standard surgical preparation","volume":"96","author":"Lee","year":"2014","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2025.08.008_bib26","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/j.jse.2014.12.026","article-title":"Low rate of Propionibacterium acnes in arthritic shoulders undergoing primary total shoulder replacement surgery using a strict specimen collection technique","volume":"24","author":"Maccioni","year":"2015","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib27","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1016\/j.jse.2020.06.019","article-title":"A break-even analysis of benzoyl peroxide and hydrogen peroxide for infection prevention in shoulder arthroplasty","volume":"29","author":"Menendez","year":"2020","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib28","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.jse.2011.02.018","article-title":"Efficacy of preoperative home use of 2% chlorhexidine gluconate cloth before shoulder surgery","volume":"20","author":"Murray","year":"2011","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib29","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.jse.2014.11.044","article-title":"Periprosthetic shoulder infection in the United States: incidence and economic burden","volume":"24","author":"Padegimas","year":"2015","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib30","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.jse.2015.08.002","article-title":"Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics","volume":"25","author":"Phadnis","year":"2016","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib31","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.jseint.2022.02.009","article-title":"Patient compliance and satisfaction with topical benzoyl peroxide gel prior to shoulder surgery","volume":"6","author":"Polce","year":"2022","journal-title":"JSES Int"},{"key":"10.1016\/j.jse.2025.08.008_bib32","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.2106\/JBJS.K.00861","article-title":"Prognostic factors for bacterial cultures positive for Propionibacterium acnes and other organisms in a large series of revision shoulder arthroplasties performed for stiffness, pain, or loosening","volume":"94","author":"Pottinger","year":"2012","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2025.08.008_bib33","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1016\/j.jse.2018.04.019","article-title":"Cutibacterium acnes and the shoulder microbiome","volume":"27","author":"Qiu","year":"2018","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib34","doi-asserted-by":"crossref","first-page":"958","DOI":"10.2106\/JBJS.17.00584","article-title":"Preoperative doxycycline does not reduce Propionibacterium acnes in shoulder arthroplasty","volume":"100","author":"Rao","year":"2018","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2025.08.008_bib35","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1177\/17585732211032523","article-title":"Evaluation of the effectiveness of skin preparation methods for the reduction of Cutibacterium acnes (formerly Propionibacterium acnes) in shoulder surgery: a systematic review","volume":"14","author":"Sagkrioti","year":"2022","journal-title":"Shoulder Elbow"},{"key":"10.1016\/j.jse.2025.08.008_bib36","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.jse.2018.02.038","article-title":"Topical benzoyl peroxide application on the shoulder reduces propionibacterium acnes: a randomized study","volume":"27","author":"Scheer","year":"2018","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib37","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/j.jse.2020.12.019","article-title":"Benzoyl peroxide treatment decreases Cutibacterium acnes in shoulder surgery, from skin incision until wound closure","volume":"30","author":"Scheer","year":"2021","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib38","doi-asserted-by":"crossref","first-page":"4422","DOI":"10.1099\/ijsem.0.001367","article-title":"The natural history of cutaneous propionibacteria, and reclassification of selected species within the genus propionibacterium to the proposed novel genera acidipropionibacterium gen. Nov., cutibacterium gen. Nov. and pseudopropionibacterium gen. nov","volume":"66","author":"Scholz","year":"2016","journal-title":"Int J Syst Evol Microbiol"},{"key":"10.1016\/j.jse.2025.08.008_bib39","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1016\/j.jse.2023.02.130","article-title":"Is there value in the routine practice of discarding the incision scalpel from the surgical field to prevent deep wound contamination with cutibacterium acnes? An update","volume":"32","author":"Shroff","year":"2023","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib40","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.jse.2019.11.037","article-title":"Strategies to decolonize the shoulder of cutibacterium acnes: a review of the literature","volume":"29","author":"Singh","year":"2020","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib41","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1016\/j.jse.2022.01.133","article-title":"The efficacy of topical preparations in reducing the incidence of Cutibacterium acnes at the start and conclusion of total shoulder arthroplasty: a randomized controlled trial","volume":"31","author":"Symonds","year":"2022","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2025.08.008_bib42","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.jse.2019.11.027","article-title":"The presence of Cutibacterium acnes on the skin of the shoulder after the use of benzoyl peroxide: a placebo-controlled, double-blinded, randomized trial","volume":"29","author":"van Diek","year":"2020","journal-title":"J Shoulder Elbow Surg"}],"container-title":["Journal of Shoulder and Elbow Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1058274625006561?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1058274625006561?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T23:33:16Z","timestamp":1773185596000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1058274625006561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S1058274625006561"],"URL":"https:\/\/doi.org\/10.1016\/j.jse.2025.08.008","relation":{},"ISSN":["1058-2746"],"issn-type":[{"value":"1058-2746","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The effect of pretreatment of the pilosebaceous unit on Cutibacterium acnes burden during shoulder arthroplasty: a randomized controlled trial","name":"articletitle","label":"Article Title"},{"value":"Journal of Shoulder and Elbow Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jse.2025.08.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.","name":"copyright","label":"Copyright"}]}}