Perioperative considerations for patient safety during cosmetic surgery – preventing complications

Abstract

A s the demand for cosmetic procedures increases, plastic surgeons are charged to maintain the highest standards for patient safety. In the past years, the issue of patient safety in health care has become a major concern of the public. The Institute of Medicine's landmark article, To Err is Human, shares the staggering statistic that between 44,000 and 98,000 Americans die each year due to medical error (1). In this report, the authors highlight patient safety as a key area in need of improvement in hospitals today. Patient safety in the operating room is a major concern for physicians, hospitals and surgical facilities alike. Physicians have an obvious investment in the safety of their patients, and surgeons are ultimately responsible for all activity that occurs during a surgical procedure.Hospitals and surgical facilities are reviewed by many national organizations that specifically review patient safety issues when determining accreditation status. As the trend of care for the cosmetic patient shifts to the outpatient facility, upholding the stringent guidelines held forth by the various accreditation groups becomes the surgeon's responsibility. Furthermore, the malpractice crisis in the United States only heightens the level of attention placed on safety issues in the operating room.Due to the elective nature of cosmetic surgery, maintaining patient safety during these procedures is especially important. In the hospital setting, much of the positioning and patient preparation is completed by nurses and anesthesiology staff. Now that plastic surgeons are performing more cosmetic Maintaining patient safety in the operating room is a major concern of surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential, and pressure to avoid these complications in cosmetic surgery is increasing. Traditionally, nursing and anesthesia staff have managed patient positioning and safety issues in the operating room. As the number of office-based procedures in the plastic surgeon's practice increases, understanding and implementing patient safety guidelines by the plastic surgeon is of increasing importance. A review of the Joint Commission's Universal Protocol highlights requirements set forth to prevent perioperative complications. In the present paper, the importance of implementing these guidelines into the cosmetic surgery practice is reviewed. Key aspects of patient safety in the operating room are outlined, including patient positioning, ocular protection and other issues essential for minimization of postoperative morbidity. Additionally, as the demand for body contouring surgery in the cosmetic practice continues to increase, special attention to safety considerations specific to the obese and massive weight loss patients is mandatory. After review of the present paper, the reader should be able to introduce the Joint Commission's Universal Protocol into their daily practice. The reader will understand key aspects of patient positioning, airway management and ocular protection i...

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