Office based dermatological surgery and Mohs surgery: A prospective audit of surgical procedures and complications in a procedural dermatology practice

Abstract

This study supports the view that dermatological surgery, including significant procedures such as Mohs micrographic surgery, flaps and grafts, can be performed on an ambulatory basis in an office-based procedure room setting, with low complication rates.

Safety of Staged Interpolation Flaps After Mohs Micrographic Surgery in an Outpatient Setting: A Single-Center Experience

“…[3][4][5][6][7] Therefore it is necessary to provide high-quality data that establishes the safety of our medical practices. Multiple prospective [8][9][10][11][12] and retrospective 13,14 studies have demonstrated the safety of MMS as performed by appropriately trained dermatologic surgeons in an outpatient setting under local anesthesia, but the number of interpolated flaps in these studies was too small to draw appropriate conclusions regarding the safety of more complicated reconstructive procedures in an ambulatory setting.…”

Complications of cutaneous surgery

“…In recent years, more retrospective and prospective analyses have been performed, capturing a wider patient cohort and resulting in a more thorough understanding of the multiple risks of scalpel‐based cutaneous surgery (see Table 1). 7‐14 …”

Patient safety in dermatologic surgery

“…Reported complications of MMS include hemorrhage/hematoma, wound infection, wound dehiscence, flap/graft necrosis, and nerve injury, occurring in approximately 0.7% to 2.6% of surgeries. [15][16][17][18][19] The largest multicenter prospective cohort of 20,821 procedures using MMS noted a 0.72% adverse event rate, the most severe of which was reported as hospitalization for infectious complications in 4 patients. 17 Notably, no deaths have been reported as a complication of MMS, despite advanced age and multiple comorbidities.…”