Perioperative management and the associated rate of adverse events in dermatological procedures performed by dermatologists in New Zealand.
Dermatological surgery performed in an outpatient setting is common and generally perceived as safe, but the potential for serious adverse events does exist. Furthermore, there is a current lack of guidelines regarding preoperative and intraoperative monitoring of such patients. This is a retrospective study that involved a written questionnaire sent to current practising New Zealand dermatologists. Aspects investigated include their practice relating to preoperative assessments and intraoperative monitoring during standard dermatological procedures, and the resulting rate of adverse events. We found that most respondents performed dermatological procedures in dedicated theatres in outpatient clinics. The majority of survey respondents would screen for and optimize risk factors prior to surgery. Most respondents would not record vital sign measurements either preoperatively or intraoperatively. Antibiotic prophylaxis was generally only prescribed if clinically indicated, and anticoagulation and antiplatelet therapies were in the majority of cases never withheld prior to surgery. Infection (<3.5%) and bleeding (<2%) were the most common postoperative complications, with other serious adverse events being extremely rare. Although dermatological surgery continues to be safely performed in the outpatient setting, attempts should still be made to identify patients who are at higher risk for surgery and extra precautions should be applied to these selected patients.
Chan
Bob C Y
BC
Department of Dermatology, Greenlane Clinical Centre, Auckland City Hospital, Auckland, New Zealand.
Patel
Denesh C
DC
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D003880:Dermatology / Q000706:statistics & numerical data*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008991:Monitoring, Physiologic; D009520:New Zealand; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012871:Skin Diseases / Q000601:surgery*; D011795:Surveys and Questionnaires