title: Complications With New Oral Anticoagulants Dabigatran and Rivaroxaban in Cutaneous Surgery.
abstract: BACKGROUND
  Anticoagulant medications to date are not associated with increased risk of severe life-threatening complications during cutaneous surgery. Dabigatran and rivaroxaban are new orally administered anticoagulants that do not require laboratory monitoring and have no available specific antidotes, making perioperative management more complex. To the authors' knowledge, published data on the use of dabigatran or rivaroxaban in patients undergoing cutaneous surgery are limited.
  
  
  OBJECTIVE
  The authors sought to study perioperative complications associated with dabigatran and rivaroxaban during cutaneous surgery.
  
  
  METHODS
  Retrospective chart analysis was performed for all patients who underwent Mohs micrographic surgery or basic excision while taking dabigatran or rivaroxaban between January 1, 2010, and September 1, 2013, at Mayo Clinic, Rochester, MN.
  
  
  RESULTS
  Twenty-seven patients taking dabigatran underwent 41 cutaneous surgeries, with only 1 mild bleeding complication observed that was remedied with a pressure dressing. Four patients on rivaroxaban underwent 5 cutaneous surgeries without complication.
  
  
  CONCLUSIONS
  Because no patients on dabigatran or rivaroxaban experienced severe hemorrhagic complications during cutaneous surgery, a strategy of continuing these medically necessary medications during cutaneous surgery seems reasonable.
authors.affiliation: *All the authors are affiliated with the Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Chang
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Arpey
authors.forename: Christian L
authors.initials: CL
authors.lastname: Baum
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Brewer
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Hochwalt
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Hocker
authors.forename: Randall K
authors.initials: RK
authors.lastname: Roenigk
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D000069604:Dabigatran; D062109:Dermatologic Surgical Procedures; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D015580:Mohs Surgery; D009025:Morpholines / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D000069552:Rivaroxaban; D012871:Skin Diseases / Q000601:surgery*; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects*; D015091:beta-Alanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D009025:Morpholines; D013876:Thiophenes; D015091:beta-Alanine; D000069552:Rivaroxaban; D000069604:Dabigatran