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Tejiram et al. Plast Aesthet Res. 2025;12:9 Plastic and
DOI: 10.20517/2347-9264.2024.109
Aesthetic Research

Original Article Open Access

Examining the effect of preoperative antibiotics for
skin grafting surgery on the microbiome in burn

patients: a pilot study

5
1,2
1,2
1
Shawn Tejiram 1,2,3,4 , John W. Keyloun , Mary A. Oliver , Desiree N. Pinto , Jeremy R. Chen See , Robert L.
1,2
1,6
5
1
1
Ball , Bonnie C. Carney , Lauren Nosanov , Melissa M. McLawhorn , Justin Wright , Regina
5,7
Lamendella , Lauren T. Moffatt 1,2,6 , Taryn E. Travis 1,2,3,4 , Jeffrey W. Shupp 1,2,3,4,6
1
Firefighters’ Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC 20010, USA.
2
The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC 20010, USA.
3
Georgetown University School of Medicine, Washington, DC 20007, USA.
4
Department of Plastic Surgery, Georgetown University School of Medicine, Washington, DC 20007, USA.
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Department of Biology, Juniata College, Huntingdon, PA 16652, USA.
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Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, DC 20007,
USA.
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Wright Labs, LLC, Huntingdon, PA 16652, USA.
Correspondence to: Dr. Shawn Tejiram, The Burn Center, Department of Surgery, MedStar Washington Hospital Center, 110
Irving Street, NW, Suite 3B-55, Washington, DC 20010, USA. E-mail: shawn.tejiram@medstar.net
How to cite this article: Tejiram S, Keyloun JW, Oliver MA, Pinto DN, Chen See JR, Ball RL, Carney BC, Nosanov L, McLawhorn
MM, Wright J, Lamendella R, Moffatt LT, Travis TE, Shupp JW. Examining the effect of preoperative antibiotics for skin grafting
surgery on the microbiome in burn patients: a pilot study. Plast Aesthet Res. 2025;12:9. https://dx.doi.org/10.20517/2347-9264.
2024.109
Received: 19 Aug 2024 First Decision: 17 Feb 2025 Revised: 3 Mar 2025 Accepted: 31 Mar 2025 Published: 11 Apr 2025
Academic Editor: Xianwen Wang Copy Editor: Ting-Ting Hu Production Editor: Ting-Ting Hu
Abstract
Aim: Severely burn injured patients present in an immunocompromised state with loss of skin integrity. Systemic
antibiotics are necessary to treat infection in this population, but even small doses may select resistant organisms
and alter the host microbiome. Despite this, preoperative antibiotics in burn injury remain debated and their impact
on the host microbiome has not been fully elucidated. This work examined the effect of a single preoperative
antibiotic dose on the microbiome and clinical outcomes in burn patients.

Methods: Patients with burns < 10% total body surface area (TBSA) requiring a single excision and grafting
operation were enrolled and randomized to receive a single preoperative dose of cefazolin (ABX) or no antibiotics
(no-ABX). Blood samples, wound swabs, and buccal swabs were obtained serially during and after hospitalization

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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