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Published on: August 21, 2020
Prospective Study of Wound Infections in Mohs Micrographic Surgery Using a Single Set of Instruments
1*Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois; †Department of Medicine, Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada.
Background:
Mohs micrographic surgery (MMS) has a low rate of surgical site infections (SSI). To date, there are variations in the measures surgeons take to prevent SSI, although these may be costly without benefit to patients.
Objective:
The purpose of the study was to evaluate the rate of SSI in MMS performed with a clean technique using a single set of instruments for both tumor extirpation and reconstruction.
Materials And Methods:
The author prospectively evaluated 338 patients undergoing MMS using a single set of instruments for SSI.
Results:
There were 7 SSI among 332 patients, with an overall infection rate of 2.1% (7/332). Graft closures had an SSI rate of 3.1% (2/64) and flap closures had an SSI rate of 1.9% (5/268).
Conclusion:
Using a single set of sterile surgical instruments for both the tumor extirpation and repair stages of MMS leads to cost savings without harming patients and maintains SSI rates within an acceptable range.
Insights
Mohs micrographic surgery (MMS) can achieve cost savings by using a single set of sterile instruments for both tumor removal and reconstruction. This approach maintains low surgical site infection (SSI) rates, demonstrating patient safety and efficiency.
Area of Science:
- Dermatology
- Surgical Oncology
- Infection Control
Background:
- Mohs micrographic surgery (MMS) is associated with a low incidence of surgical site infections (SSI).
- Current practices for SSI prevention in MMS vary among surgeons.
- Some preventative measures may incur costs without clear patient benefit.
Purpose of the Study:
- To assess the SSI rate in MMS procedures utilizing a clean technique.
- To evaluate the efficacy of employing a single instrument set for both tumor extirpation and reconstruction phases.
Main Methods:
- Prospective evaluation of 338 patients undergoing MMS.
- Standardized clean technique with a single set of instruments for all surgical steps.
- Monitoring for and recording of all SSIs.
Main Results:
- An overall SSI rate of 2.1% (7/332) was observed.
- Graft closures exhibited an SSI rate of 3.1% (2/64).
- Flap closures demonstrated an SSI rate of 1.9% (5/268).
Conclusions:
- A single set of sterile surgical instruments for MMS tumor extirpation and reconstruction is cost-effective.
- This approach does not compromise patient safety, maintaining acceptable SSI rates.
- Streamlining instrument usage in MMS offers financial benefits without increasing infection risk.
