Shared decision making for perioperative antibiotic use during Mohs micrographic surgery on the lower extremities Journal Article


Authors: Fronek, L.; Davis, M. J.; Greenway, H. T.; Kelley, B.
Article Title: Shared decision making for perioperative antibiotic use during Mohs micrographic surgery on the lower extremities
Abstract: Background: While there is a higher risk of surgical site infection (SSI) on the lower extremities following Mohs micrographic surgery (MMS), antibiotic prophylaxis (AP) is debated. Objective: To determine the role of shared decision making (SDM) in guiding AP usage during MMS on the lower extremities. Materials and methods: A prospective observational study was conducted whereby patients received a standardized SDM discussion or routine counseling. Patient satisfaction quantified by the shared decision-making questionnaire (SDMQ9) survey, rate of SSI, and rate of AP prescription were recorded. Results: In total, 51 patients were included. While there were less antibiotics prescribed in the treatment group (20% versus 50%, P = .025), this did not affect incidence of SSI (8% in treatment group versus 7.7% in control group, P = .668). Patient satisfaction was statistically greater in SDM group (4.73 versus 2.18 in control (P < .001). Conclusion: Patient satisfaction scores were higher among the patients who received SDM. While the usage of AP was lower in the SDM group, this did not affect incidence of SSI. This study allows the opportunity to apply SDM in the setting of MMS, which to our knowledge has not yet been attempted in the field of dermatologic surgery. © 2024 American Academy of Dermatology, Inc.
Keywords: adult; controlled study; middle aged; patient satisfaction; antibiotic agent; antibiotic therapy; major clinical study; prospective study; pain; basal cell carcinoma; health survey; fever; wound healing; prescription; questionnaire; surgical infection; erythema; perioperative period; informed consent; observational study; antibiotic prophylaxis; mohs surgery; mohs micrographic surgery; skin graft; shared decision making; principal component analysis; demographics; split thickness skin graft; human; male; female; article; exploratory factor analysis; lower limb; perioperative medicine; suture technique; postoperative skin infection
Journal Title: JAAD International
Volume: 16
ISSN: 2666-3287
Publisher: Elsevier BV  
Date Published: 2024-09-01
Start Page: 155
End Page: 162
Language: English
DOI: 10.1016/j.jdin.2024.03.011
PROVIDER: scopus
PMCID: PMC11245999
PUBMED: 39006918
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Michael James Davis
    11 Davis