Outpatient dermatology major surgery: a 1‐year experience in a Spanish tertiary hospital

Abstract

Medium and high complexity operations for dermatological processes, traditionally performed on hospitalized patients, can be conducted on an outpatient basis. This allows hospitalization costs and waiting lists to be reduced and affords the possibility of achieving better morbidity rates and medical care than in the standard hospital setting.

Topical antibiotic prophylaxis for prevention of surgical wound infections from dermatologic procedures: a systematic review and meta-analysis

“…Since most wound infections occur as a result of contamination before wound closure, administering topical antibiotics postoperatively is not an effective measure to prevent postsurgical wound infections (34). The rates of postsurgical wound infection in the modern-day outpatient dermatologic setting are low, typically ranging from 0.7% to 4.0% (12)(13)(14)(15)18,21,23,27,28,31,32,(35)(36)(37)(38) even without prophylactic antibiotics secondary to current aseptic practices, such as preoperative surgical site preparation, sterilization of instruments and wearing gloves (4,22,(39)(40)(41). Furthermore, most of the wound infections that develop in this setting are mild and easily treated, frequently with basic wound care management alone and no antibiotics (34).…”

Evaluation of the treatment of non‐melanoma skin cancers by surgical excision

“…27 In a separate internal audit of BCC and SCC excised by dermatologists (excluding MMS) in New Zealand, the incomplete excision rate was 0.56% (9/1615), which is the lowest thus reported. 27 10 Plastic surgeons and registrars, tertiary referral centre 480 6.3 22 Dermatologists, outpatient surgery based in tertiary hospital 117 5.2 23 Head and neck squamous cell carcinoma, maxillofacial unit in two hospitals 227 7.0 24 Tertiary referral centre 63 15.9 25 Plastic surgeons in a university medical centre 369 6.8…”

Complications of ambulatory major dermatological surgery in patients older than 85 years

“…Although we do not have a control group of young population, we have previously studied all patients who underwent dermatological AMS in our hospital during 2003 13 . From 644 patients, 17 developed local complications: 14 of 546 patients were younger than 85 years (2.6%) and 3 of 98 were older than 85 years (3.0%), so no statistical differences were detected.…”

“…Ambulatory Major Surgery includes a group of surgical techniques of moderate complexity that can be implemented under any kind of anaesthesia on patients who can receive post-operative care and be discharged on the same day (after a few hours of observation). 13 Dermatological surgery has been incorporated in many AMS 14,15 because of increasing incidence of skin cancer, [16][17][18] the current trend of performing surgical treatment of cutaneous diseases, [18][19][20][21][22] the purpose of reducing the stay in hospital, 21 and the higher complexity of dermatological surgery techniques. 18,19,22 Some studies 3,4,6,23 suggest that AMS provides unquestionable advantages for the management of elderly patients.…”

“…Criteria for inclusion as major surgery in our AMS unit were as follows: 13 1 Related to the cutaneous process: removal of large or multiple tumours, or those which reconstruction requires complex surgery procedures that may last closure more than 30 min. 2 Related to the patient: removal of lesions in patients with medical problems that may extend the length of intervention, who may suffer intra ⁄ post-operative complications, or who require sedation, spinal or general anaesthesia.…”