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Related Experiment Video

Updated: Dec 21, 2025

Author Spotlight: Advancing Endoscopic Ossiculoplasty &#8211; Techniques, Innovations, and Practical Guidance for Clinical Integration
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Do Postoperative Antibiotics Affect Outcomes in Mohs Reconstructive Surgery?

Matthew Q Miller1, Jacqueline S Stevens2, Stephen S Park1

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.

The Laryngoscope
|May 14, 2020
PubMed
Summary

Routine postoperative antibiotics after Mohs reconstructive surgery do not reduce infection risk. Targeted antibiotic use is recommended to combat rising antibiotic resistance and improve patient outcomes in Mohs reconstruction.

Keywords:
Facial plastics/reconstructive surgerynasal reconstructionwound healing

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Area of Science:

  • Dermatology
  • Plastic Surgery
  • Infectious Disease

Background:

  • Antibiotic prescribing for Mohs reconstructive surgery has risen.
  • Antibiotic resistance is a growing global health concern.
  • The efficacy of routine postoperative antibiotics in preventing surgical site infections (SSIs) after Mohs reconstruction is questionable.

Purpose of the Study:

  • To investigate the association between postoperative antibiotic use and SSIs following Mohs reconstructive surgery.
  • To identify risk factors for SSIs in patients undergoing Mohs reconstruction.

Main Methods:

  • Retrospective cohort study of 800 patients (900 defects) from January 2012 to January 2019.
  • Analysis of patient-specific (comorbidities, age, smoking) and surgery-specific variables (defect characteristics, reconstruction type, antibiotic use).
  • Outcomes assessed: SSIs, flap/graft necrosis, hematoma, dehiscence.

Main Results:

  • Smoking and cartilage grafts were significantly associated with increased SSI risk (OR: 6.67 and 6.53, respectively).
  • Full-thickness defects and interpolated flap reconstruction also showed increased SSI risk.
  • Perioperative antibiotic use was not associated with a reduced risk of infection (OR: 1.82; P = .568).

Conclusions:

  • No association was found between postoperative antibiotic use and reduced SSIs after Mohs reconstructive surgery.
  • Current data suggest a more targeted approach to antibiotic prescribing is warranted.
  • This supports judicious antibiotic stewardship in Mohs reconstructive surgery.