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Chap. 2 - CLEAN AND ASEPTIC TECHNIQUE AT THE BEDSIDE
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- By Sapna Amin, Baylor College of Medicine, Aron J. Gewirtzman, Albert Einstein College of Medicine, Stephen Tyring, University of Texas Health Science Center
- Edited by Ronni Wolf, Batya B. Davidovici, Jennifer L. Parish, Lawrence Charles Parish
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- Book:
- Emergency Dermatology
- Published online:
- 07 September 2011
- Print publication:
- 17 January 2011, pp 12-17
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- Chapter
- Export citation
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Summary
CUTANEOUS SURGICAL INTERVENTIONS are becoming more and more popular as this area of dermatology continues to rapidly expand. Dermatologists are performing progressively more surgical procedures in their private offices. A survey performed by the American Society of Dermatologic Surgery (ASDS) in 2003 revealed that 3.9 million procedures were performed that year by participating ASDS members. These outpatient procedures allow the dermatologist to provide more comprehensive care to the patient and present the patient with a more affordable option, because outpatient procedures under local anesthesia are less expensive than in the hospital setting.
With the upsurge in the number of cutaneous surgeries, an important goal remains to keep patients free of nosocomial and surgical site infections (SSIs). Traditionally, dermatologic procedures and surgeries have benefited from relatively low infection rates, despite varying infection-control practices. Strict adherence to aseptic technique is required to maintain this low rate of infectious complications. In addition to the principles of asepsis, the surgeon must also minimize patient and environmental risk factors, achieve adequate preoperative preparation, decide if antibiotic prophylaxis is necessary, as well as maintain proper surgical suite protocol and surgical technique.
SURGICAL SITE INFECTIONS
Postoperative infections after dermatologic procedures are rare. These surgeries are largely considered either “clean” or “clean-contaminated,” with infection rates of less than 5% and 5%–10%, respectively. Studies examining the rate of infectious complications following dermatologic procedures have indicated an even lower incidence in this field.