title: Analysis of results, quality indicators, and postsurgical complications in an outpatient dermatological surgery program.
abstract: OBJECTIVE
  To evaluate the results of an outpatient program for major dermatological surgery in patients with a range of skin conditions.
  
  
  METHODS
  We undertook a retrospective, observational study of patients who underwent scheduled dermatological surgery as outpatients in a public hospital between 2004 and 2007. The most common procedures were excision of basal cell or squamous cell carcinoma with or without graft reconstruction. The rates of substitution (of inpatient procedures), cancellation, hospital admission, and readmission were analyzed along with service utilization and systemic complications arising within the first 72 h of surgery. Variables were analyzed as relative frequencies. The occurrence of complications during the study period was analyzed by chi square test.
  
  
  RESULTS
  A total of 2789 patients underwent surgery during the study period, and of those, 2757 procedures were performed on an outpatient basis (overall substitution rate, 17.99%). The service utilization was 74.36%. Fourteen patients were admitted to hospital following surgery (2.62%), and of those 12 were admitted immediately (85.71%). Nine patients had serious complications (cardiovascular, neurological, metabolic, or infectious), representing a proportional risk of 1:59. Less serious complications (hypertension, nausea, vomiting, and vasovagal syncope) requiring hospital admission occurred in 25 patients.
  
  
  CONCLUSIONS
  Major surgery undertaken on an outpatient basis is an excellent multidisciplinary surgical care model that allows well-selected patients to be treated effectively, safely, and efficiently. A small percentage of postoperative complications of varying severity can still occur despite patients' meeting optimal criteria for success. Fortunately, however, the rate of mortality is practically zero.
authors.affiliation: FEA Servicio de Anestesiología y Reanimación, Hospital de Torrecárdenas de Almería, Spain. stl967523977@wanadoo.es
authors.forename: M
authors.initials: M
authors.lastname: Cortiñas Saenz
authors.forename: S
authors.initials: S
authors.lastname: Sáenz Guirado
authors.forename: J
authors.initials: J
authors.lastname: Gamez Moreno
authors.forename: J A
authors.initials: JA
authors.lastname: Iglesias Cerrillo
authors.forename: A
authors.initials: A
authors.lastname: Pardo Martinez
authors.forename: L
authors.initials: L
authors.lastname: Martínez Gomez
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms / Q000706:statistics & numerical data; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012871:Skin Diseases / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery; D013030:Spain / Q000453:epidemiology; D013531:Surgicenters / Q000706:statistics & numerical data*; D016896:Treatment Outcome