title: Multiple antithrombotic agents increase the risk of postoperative hemorrhage in dermatologic surgery.
abstract: BACKGROUND
  Studies show that holding single antithrombotic agents perioperatively increases the risk of acute thrombotic events and does not significantly decrease the risk of bleeding complications in dermatological surgery. Recent data suggest that selected patients may benefit from combination therapy in preventing acute thrombotic events.
  
  
  OBJECTIVE
  We sought to evaluate postoperative bleeding complications in patients who underwent Mohs micrographic surgery while using multiple agents perioperatively compared with patients using a single agent or none at all.
  
  
  METHODS
  We conducted a retrospective chart review of patients treated in one academic Mohs micrographic surgery department during 1 year.
  
  
  RESULTS
  Patients taking two or more agents at the time of surgery were more likely to bleed than those taking one agent or none at all (P = .0016, Fisher's exact).
  
  
  CONCLUSIONS
  Small sample size and retrospective nature were limitations.
  
  
  CONCLUSIONS
  Perioperative use of more than one antithrombotic agent increases postoperative bleeding risk.
authors.affiliation: Warren Alpert Medical School of Brown University, Providence, Rhode Island 01903, USA.
authors.forename: Ikue
authors.initials: I
authors.lastname: Shimizu
authors.forename: Nathaniel J
authors.initials: NJ
authors.lastname: Jellinek
authors.forename: Raymond G
authors.initials: RG
authors.lastname: Dufresne
authors.forename: Tianyu
authors.initials: T
authors.lastname: Li
authors.forename: Karthik
authors.initials: K
authors.lastname: Devarajan
authors.forename: Clifford
authors.initials: C
authors.lastname: Perlis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000139:chemically induced*; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000601:surgery*
chemical_list: D005343:Fibrinolytic Agents