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

Mohs surgery antibiotic prophylaxis postoperative skin infection shared decision making

Journal

JAAD international
ISSN: 2666-3287
Titre abrégé: JAAD Int
Pays: United States
ID NLM: 101774762

Informations de publication

Date de publication:
Sep 2024
Historique:
accepted: 16 03 2024
medline: 15 7 2024
pubmed: 15 7 2024
entrez: 15 7 2024
Statut: epublish

Résumé

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. To determine the role of shared decision making (SDM) in guiding AP usage during MMS on the lower extremities. 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. In total, 51 patients were included. While there were less antibiotics prescribed in the treatment group (20% versus 50%, 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.

Sections du résumé

Background UNASSIGNED
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 UNASSIGNED
To determine the role of shared decision making (SDM) in guiding AP usage during MMS on the lower extremities.
Materials and methods UNASSIGNED
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 UNASSIGNED
In total, 51 patients were included. While there were less antibiotics prescribed in the treatment group (20% versus 50%,
Conclusion UNASSIGNED
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.

Identifiants

pubmed: 39006918
doi: 10.1016/j.jdin.2024.03.011
pii: S2666-3287(24)00049-X
pmc: PMC11245999
doi:

Types de publication

Journal Article

Langues

eng

Pagination

155-162

Informations de copyright

© 2024 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

None disclosed.

Auteurs

Lisa Fronek (L)

Department of Dermatology, Scripps Clinic Torrey Pines Bighorn Mohs Surgery and Dermatology, San Diego, California.

Michael J Davis (MJ)

Department of Dermatology, Memorial Sloan Kettering, Mohs Micrographic Surgery, New York, New York.

Hubert T Greenway (HT)

Department of Dermatology, Scripps Clinic Torrey Pines Bighorn Mohs Surgery and Dermatology, San Diego, California.

Benjamin Kelley (B)

Department of Dermatology, Scripps Clinic Torrey Pines Bighorn Mohs Surgery and Dermatology, San Diego, California.

Classifications MeSH