Optimizing Patient Safety in Dermatologic Surgery

Smith, Cory; Srivastava, Divya; Nijhawan, Rajiv I.

doi:10.1016/j.det.2019.02.006

Cited by 4 publications

(3 citation statements)

References 56 publications

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“…The implementation of accurate and consistent anatomic mapping in dermatology has many potential advantages. 7,[12][13][14] The current inconsistent anatomic terminology can lead to erroneous surgery site, particularly when multiple biopsies are concurrently done on a patient. In addition, communication on precise anatomic location is critical when a lesion is initially biopsied by a dermatologist and then referred elsewhere for definitive surgery.…”

Section: Discussionmentioning

confidence: 99%

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Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration

Navarrete‐Dechent

Liopyris

Molenda³

et al. 2020

Acad Dermatol Venereol

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Background There is no internationally vetted set of anatomic terms to describe human surface anatomy. Objective To establish expert consensus on a standardized set of terms that describe clinically relevant human surface anatomy. Methods We conducted a Delphi consensus on surface anatomy terminology between July 2017 and July 2019. The initial survey included 385 anatomic terms, organized in seven levels of hierarchy. If agreement exceeded the 75% established threshold, the term was considered 'accepted' and included in the final list. Terms added by the participants were passed on to the next round of consensus. Terms with <75% agreement were included in subsequent surveys along with alternative terms proposed by participants until agreement was reached on all terms. Results The Delphi included 21 participants. We found consensus (≥75% agreement) on 361/385 (93.8%) terms and eliminated one term in the first round. Of 49 new terms suggested by participants, 45 were added via consensus. To adjust for a recently published International Classification of Diseases-Surface Topography list of terms, a third survey including 111 discrepant terms was sent to participants. Finally, a total of 513 terms reached agreement via the Delphi method. Conclusions We have established a set of 513 clinically relevant terms for denoting human surface anatomy, towards the use of standardized terminology in dermatologic documentation.

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Section: Discussionmentioning

confidence: 99%

“…The implementation of accurate and consistent anatomic mapping in dermatology has many potential advantages 7,12–14 . The current inconsistent anatomic terminology can lead to erroneous surgery site, particularly when multiple biopsies are concurrently done on a patient.…”

Section: Discussionmentioning

confidence: 99%

Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration

Navarrete‐Dechent

Liopyris

Molenda³

et al. 2020

Acad Dermatol Venereol

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“…Presently, the CDC recommends alcohol-based sanitation to be used predominantly, although handwashing with soap and water is preferred before eating, after using the restroom, when hands are visibly soiled, and when Clostridium difficile exposure is suspected [31,32]. A strict surgical hand scrub that generally includes cleaning one's hands up to the forearm with a brush has not been tested in dermatology, and such a protocol is likely unnecessary in the dermatology practice.…”

Section: Handwashingmentioning

confidence: 99%

Reappraising Elements of the Aseptic Technique in Dermatology: A Review

Khan

Shih

et al. 2021

Dermatol Pract Concept

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Dermatologic procedures are performed under varying degrees of antisepsis, and no clear guidelines exist regarding the role of the aseptic technique in dermatology. This review aims to clarify the terminology surrounding surgical asepsis and examines the importance of various components of the aseptic technique in cutaneous surgery. Included are studies examining optimal glove type, surgical instruments, skin antisepsis, and cost-reducing protocols. Our review highlights that most dermatology procedures are not performed under completely sterile conditions due to the lack of environmental and foot traffic controls in dermatology offices. In addition, for some outpatient procedures, such as for minor excisions and Mohs surgery before reconstruction, elements of the clean technique can be used without increasing infection rates. However, data on the feasibility of a clean protocol for Mohs reconstruction is conflicting. Future prospective, randomized trials analyzing various components of the aseptic technique in dermatology are greatly needed so that guidelines can be established for practicing dermatologists.

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