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Scientific Oral Presentation

Facial Plastic and Reconstructive Surgery

Efficacy of Prophylactic Postoperative Antibiotics in Facial Mohs Reconstruction

Saturday, October 17, 2026
3:06 PM - 3:12 PM PT
Location: 404A

    Presenting Author(s)

  • Bao Y. Sciscent, MD

    Resident Physician
    Department of Otolaryngology-Head & Neck Surgery, University of Virginia
    Charlottesville, VA, United States

    • Co-Author(s)

  • PY

    Peyton Yee, BS

    Medical Student
    Department of Otolaryngology-Head & Neck Surgery, University of Virginia
    Charlottesville, Virginia, United States

    • Senior Author(s)

  • SO

    Samuel L. Oyer, MD

    Associate Professor
    Department of Otolaryngology-Head & Neck Surgery, University of Virginia
    Charlottesville, VA, United States

Disclosure(s):
Bao Y. Sciscent, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Samuel L. Oyer, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Mohs micrographic surgery (MMS) is associated with low postoperative infection rates. However, approximately 75% of surgeons prescribe prophylactic antibiotics despite increasing rates of antibiotic resistance and costs. This systematic review and meta-analysis test the hypothesis that postoperative antibiotic prophylaxis reduces infections following facial reconstruction for Mohs defects compared to no prophylactic antibiotics.

Methods: PRISMA guidelines were followed to systematically search the PubMed, Embase, OVID, and Web of Science databases from inception to January 2026. Studies reporting infection rates in patients undergoing facial reconstruction after MMS, with or without postoperative antibiotics, were included.

Results: Of 2,073 unique studies identified, 19 met the inclusion criteria for a systematic review (3,686 cases). Four studies specifically compared infection rates between patients who received postoperative antibiotics and those who did not. Of these, three studies were pooled for analysis using a random-effects model. The fourth study was a double-arm, zero-event study and was excluded. In total, there were 2,353 facial defects and 2,645 reconstructions (Flaps: 80.57%; n=2,131 and Grafts: 19.43%; n=514) across 2,253 patients. A total of 37.06% (n=835) of patients were prescribed antibiotic prophylaxis, and 62.94% (n=1,418) were not. Infection rates were 1.92% in patients receiving antibiotics and 1.20% in those not receiving antibiotics. Use of prophylactic postoperative antibiotics was not significantly associated with a decreased risk of infection (RR 1.83 [95%CI, 0.58-5.81]).

Conclusions: The use of prophylactic postoperative antibiotics was not associated with a decreased risk of infection. Routine postoperative antibiotics may not be necessary for most patients undergoing facial Mohs reconstruction.