Multiple antithrombotic agents increase the risk of postoperative hemorrhage in dermatologic surgery

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). Limitations: Small sample size and retrospective nature were limitations. Conclusion: Perioperative use of more than one antithrombotic agent increases postoperative bleeding risk.