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Perioperative Practices in Dermatologic Surgery

Stephen P Erickson1, Samantha L Schneider2, Joel L Cohen3,4

  • 1Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]
|July 21, 2022
PubMed
Abstract

Insights

Dermatologic surgeons exhibit variable perioperative practices, including antibiotic prophylaxis and medication management, potentially deviating from guidelines. Standardization and updated guidelines are needed for Mohs surgery patient care.

Area of Science:

  • Dermatologic Surgery
  • Surgical Oncology
  • Patient Safety

Background:

  • Mohs micrographic surgery is a widely used, safe procedure.
  • Current perioperative practices vary, with limited data on their effectiveness in preventing adverse events.

Purpose of the Study:

  • To evaluate current perioperative practices among dermatologic surgeons.
  • Focus areas include antibiotic prophylaxis, anticoagulation management, activity restrictions, and antiseptic selection.

Main Methods:

  • Two surveys were distributed to members of the American College of Mohs Surgery (ACMS) and the American Society for Mohs Surgery (ASMS).
  • 177 surgeons participated, representing diverse organizational affiliations.

Main Results:

  • High rates of preoperative (96%) and postoperative (91%) antibiotic prophylaxis were reported.
  • Therapeutic anticoagulants were rarely discontinued, but preventative aspirin (30%), NSAIDs (25%), and anticoagulant supplements (54%) were more frequently held.
  • Practices regarding antiseptic choice and activity restrictions showed variability.

Conclusions:

  • Dermatologic surgeons' perioperative practices are inconsistent and may not align with existing guidelines.
  • There is a clear need for standardized protocols and updated guidelines to improve perioperative care in dermatologic surgery.

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