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Opioid Prescribing Patterns After Micrographic Surgery

A Follow-up Retrospective Chart Review

Donigan, Jessica M., MD*; Franco, Abigail I., MD; Stoddard, Gregory J., MS; Hedderman, Amanda, CMA§; Tristani-Firouzi, Payam, MD§; Bowen, Glen M., MD§; Millican, Eric A., MD§; Duffy, Keith L., MD§

doi: 10.1097/DSS.0000000000001725
Original Article

BACKGROUND The abuse of opioids has reached epidemic proportions in the United States, and leftover medications are a primary source for nonmedical pain relievers. A past study at the University of Utah showed that micrographic surgeons were likely overprescribing opioids, with 35% of patients receiving a postoperative prescription.

OBJECTIVE To examine the current opioid prescribing habits of the micrographic surgeons at the University of Utah compared with those in 2010.

METHODS Retrospective chart review of the patient records of 4 micrographic surgeons between February and May 2017.

RESULTS Four hundred patient visits were reviewed. An opioid prescription was provided after 12% of encounters, 23% lower than in 2010 (p = .004). Younger patient age, increased number of stages and defect size, repair of the defect, and particular surgeons predicted opioid prescription.

CONCLUSION The percentage of patients who received an opioid prescription after undergoing micrographic surgery at the University of Utah decreased from 35% in 2010 to 12% in 2017. Reports of the minimal need of opioids after micrographic surgery, the authors' past study showing an institutional tendency to overprescribe, and reports of the national opioid epidemic likely all contributed to the decrease in opioid prescriptions at the authors' institution.

*School of Medicine, University of Utah, Salt Lake City, Utah;

Department of Family Medicine, St. Joseph's Hospital Health Center, Syracuse, New York;

Department of Internal Medicine, University of Utah, Salt Lake City, Utah;

§Department of Dermatology, University of Utah, Salt Lake City, Utah; J. Donigan is currently affiliated with the Department of Dermatology, University of Texas Southwestern, Dallas, Texas; A. Franco is currently affiliated with the Department of Dermatology, University of Rochester Medical Center, Rochester, New York; P. Tristani-Firouzi is currently affiliated with Revere Health, Provo, Utah.

Address correspondence and reprint requests to: Jessica M. Donigan, MD, School of Medicine, 30 North 1900 East, 4A330 Salt Lake City, UT 84132, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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