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Incidence of infection after Mohs micrographic and dermatologic surgery before and after implementation of new
1Division of Dermatology, Cooper University Hospital Medical Center, Marlton, New Jersey.
Background:
Clinical guidelines regarding surgical instrument sterilization established by accrediting organizations should be based on peer-reviewed scientific literature. Few data exist in the scientific literature to support the changes in sterilization protocols imposed by accrediting organizations.
Objective:
We sought to determine whether recently established guidelines for the sterilization of surgical instruments have had any clinical impact on postsurgical infection rates.
Methods:
Infections rates after excisional and Mohs micrographic surgery before and after implementation of new Joint Commission on the Accreditation of Healthcare Organizations sterilization guidelines were examined retrospectively. All surgeries were performed at an academic outpatient office.
Results:
In all, 1415 patients underwent a total of 1688 surgeries. No significant differences were observed in mean patient age (P = .113), mean number of Mohs micrographic surgical levels (P = .067), final defect size (P = .305), patient gender (P = .072), repair type (P = .691), or infection rate (P = .453). No major differences in predisposing factors were identified in patients who developed postsurgical infections.
Limitations:
This was a retrospective study conducted at a single academic institution.
Conclusions:
In our practice, recent changes in surgical instrument sterilization protocols have had no impact on postsurgical infection rates. The implementation of such guidelines places an additional burden on the health care system without providing any improvement in patient outcomes.
Insights
New sterilization guidelines for surgical instruments did not reduce postsurgical infection rates in our study. Implementing these protocols adds burdens without improving patient outcomes.
Area of Science:
- Infection Control
- Surgical Procedures
- Healthcare Policy
Background:
- Clinical guidelines for surgical instrument sterilization should be evidence-based.
- Limited scientific data support recent sterilization protocol changes mandated by accrediting organizations.
Purpose of the Study:
- To assess the clinical impact of new surgical instrument sterilization guidelines on postsurgical infection rates.
- To determine if updated sterilization protocols affect patient outcomes.
Main Methods:
- Retrospective analysis of infection rates before and after implementing new sterilization guidelines.
- Study included excisional and Mohs micrographic surgery at an academic outpatient facility.
Main Results:
- 1688 surgeries across 1415 patients were analyzed.
- No significant differences were found in infection rates, patient demographics, or surgical factors.
- Predisposing factors for infection did not differ between groups.
Conclusions:
- Recent changes in sterilization protocols had no discernible impact on postsurgical infection rates in this practice.
- Current guidelines may impose additional healthcare burdens without demonstrable patient benefit.
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