Skip to main content
SpringerLink
Log in

Optimizing Surgical Outcomes

  • Chapter
  • First Online:
Skin Cancer Management

  • 1173 Accesses

Abstract

To optimize outcomes associated with cutaneous procedures the surgeon must consider multiple factors. Many of these factors should be addressed prior to the start of surgery and others require attention during or after the procedure. Recognition of these factors can aid in the meticulous planning and attention to detail necessary to obtain the best outcome following surgical treatment of skin cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Procedure Survey. Dermasurgery Trends and Statistics. Rolling Meadows, IL: American Society for Dermatologic Surgery; 2005. Available from: http://www.asds.net/TheAmericanSocietyforDermatologicSurgeryReleasesNewProcedureSurveyData.aspx. Last accessed February 3, 2009.

  2. Kaplan AL, Weitzul SB, Taylor RS. Longitudinal diminution of tumor size for basal cell carcinoma suggests shifting referral patterns for Mohs surgery. Dermatol Surg. 2008;34:15–19.

    Article  CAS  PubMed  Google Scholar 

  3. Cook J, Zitelli JA. Mohs micrographic surgery: a cost analysis. J Am Acad Dermatol. 1998;39:698–703.

    Article  CAS  PubMed  Google Scholar 

  4. Kovich O, Otley CC. Perioperative management of anticoagulants and platelet inhibitors for cutaneous surgery: a survey of current practice. Dermatol Surg. 2002;28:513–517.

    Article  PubMed  Google Scholar 

  5. Otley CC. Continuation of medically necessary aspirin and warfarin during cutaneous surgery. Mayo Clin Proc. 2003;78:1392–1396.

    Article  PubMed  Google Scholar 

  6. Alcalay J, Alkalay R. Controversies in perioperative management of blood thinners in dermatologic surgery: continue or discontinue? Dermatol Surg. 2004;30:1091–1094.

    Article  PubMed  Google Scholar 

  7. Schanbacker CF, Bennett RG. Postoperative stroke after stopping warfarin for cutaneous surgery. Dermatol Surg. 2000;26:785–789.

    Article  Google Scholar 

  8. Alam M, Goldberg LH. Serious adverse vascular events associated with perioperative interruption of antiplatelet and anticoagulant therapy. Dermatol Surg. 2002;28992–998.

    Article  PubMed  Google Scholar 

  9. Kovich O, Otley CC. Thrombotic complications related to discontinuation of warfarin and aspirin therapy perioperatively for cutaneous operation. J Am Acad Dermatol. 2003;48:233–237.

    Article  PubMed  Google Scholar 

  10. Chang LK, Whitaker DC. The impact of herbal medicines on dermatologic surgery. Dermatol Surg. 2001;27:759–763.

    Article  CAS  PubMed  Google Scholar 

  11. Timbo BB, Ross MP, McCarthy PV, et al. Dietary supplements in a national survey: Prevalence of use and reports of adverse events. J Am Diet Assoc. 2006;106:1966–1974.

    Article  CAS  PubMed  Google Scholar 

  12. Cox AC, Rao GH, Gerrard JM, White JG. The influence of vitamin E quinone on platelet structure, function, and biochemistry. Blood. 1980;55:907–914.

    CAS  PubMed  Google Scholar 

  13. Ziv O, Ragni MV. Bleeding manifestations in males with von Willebrand disease. Haemophilia. 2004;10:162–168.

    Article  CAS  PubMed  Google Scholar 

  14. Werner EJ, Broxson EH, Tucker EL, et al. Prevalence of von Willebrand disease in children: a multiethnic study. J Pediatr. 1993;123:893–898.

    Article  CAS  PubMed  Google Scholar 

  15. Leonard AL, Hanke CW, Greist A. Perioperative management of von Willebrand disease in dermatologic surgery. Dermatol Surg. 2007;33:403–409.

    Article  CAS  PubMed  Google Scholar 

  16. Nichols WC, Ginsburg D. Von Willebrand disease. Medicine (Baltimore ). 1997;76:1–20.

    Article  CAS  Google Scholar 

  17. Bailey BJ, Johnson JT, Newlands SD. Head & Neck Surgery—Otolaryngology. Philadelphia: Lippincott Williams & Wilkins; 2006:217.

    Google Scholar 

  18. Busti AJ, Hooper JS, Amaya CJ, Kazi S. Effects of perioperative anti-inflammatory and immunomodulating therapy on surgical wound healing. Pharmacotherapy. 2005;25:1566–1591.

    Article  CAS  PubMed  Google Scholar 

  19. Abdelmalek M, Spencer J. Retinoids and wound healing. Dermatol Surg. 2006;32:1219–1230.

    Article  CAS  PubMed  Google Scholar 

  20. Taniguchi Y, Shimizu Y, Inachi S, Shimizu M. Skin surgery in patients 90 years of age and over. Int J Dermatol. 1998;37:547–550.

    Article  CAS  PubMed  Google Scholar 

  21. MacFarlane DF, Pustelny BL, Goldberg LH. An assessment of the suitability of Mohs micrographic surgery in patients aged 90 years and older. Dermatol Surg. 1998;23:389–392.

    Article  Google Scholar 

  22. Berman B, Flores F. The treatment of hypertrophic scars and keloids. Eur J Dermatol. 1998;8:591–595.

    CAS  PubMed  Google Scholar 

  23. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis guidelines from the American Heart Association. Circulation. 2007;116:1736–1754.

    Article  PubMed  Google Scholar 

  24. Scher K, Elston DM, Hedrick JA, Joseph WS, Maurer T, Murakawa GJ. Treatment options in the management of uncomplicated skin and skin structure infections. Cutis. 2005;75:3–23.

    PubMed  Google Scholar 

  25. American Academy of Orthopaedic Surgeons Advisory Statement on Antibiotic Prophylaxis for Dental Patients with Total Joint Replacements. http://www.aaos.org/about/papers/advistmt/1027.asp. Last accessed January 21, 2009.

  26. Wright TI, Baddour LM, Berbari EF. Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008. J Am Acad Dermatol. 2008;59:464–473.

    Article  PubMed  Google Scholar 

  27. Sheridan RL, Schulz JT, Weber JM, et al. Cutaneous herpetic infections complicating burns. Burns. 2000;26:621–624.

    Article  CAS  PubMed  Google Scholar 

  28. Fidler PE, Mackool BT, Schoenfeld DA, et al. Incidence, outcome, and long-term consequences of herpes simplex virus type 1 reactivation presenting as a facial rash in intubated adult burn patients treated with acyclovir. J Trauma. 2002;53:86–89.

    Article  PubMed  Google Scholar 

  29. Verrill PJ. Adverse reactions to local anaesthetics and vasoconstrictor drugs. Practitioner. 1975;214: 380–387.

    CAS  PubMed  Google Scholar 

  30. Amsler E, Flahault A, Mathelier-Fusade P, Aractingi S. Evaluation of re-challenge in patients with suspected lidocaine allergy. Dermatology. 2004;208:109–111.

    Article  CAS  PubMed  Google Scholar 

  31. Dire DJ. Hogan DE. Double-blinded comparison of diphenhydramine versus lidocaine as a local anesthetic. Ann Emerg Med. 1993;22:1419–1422.

    Article  CAS  PubMed  Google Scholar 

  32. Romano A, Gueant-Rodriguez RM, Viola M, Pettinato R, Gueant JL. Cross-reactivity and tolerability of cephalosporins in patients with immediate hypersensitivity to penicillins. Ann Intern Med. 2004;141:16–22.

    CAS  PubMed  Google Scholar 

  33. El-Gamal HM, Dufresne RG, Saddler K. Electrosurgery, pacemakers, and ICDs: a survey of precautions and complications experienced by cutaneous surgeons. Dermatol Surg. 2001;27:385–390.

    Article  CAS  PubMed  Google Scholar 

  34. Lane JE, O’Brien EM, Kent DE. Optimization of thermocautery in excisional dermatologic surgery. Dermatol Surg. 2006;32:669–675.

    Article  CAS  PubMed  Google Scholar 

  35. Haines RC Jr, Brooks LR. Office space planning and design for medical practices, Part 1: an overview. J Med Pract Manage. 2003;18:244–249.

    PubMed  Google Scholar 

  36. Haines RC Jr, Griffin JK. Office space planning and design for medical practices: Part 3, Implementation, design, and construction. J Med Pract Manage. 2003;19:19–26.

    PubMed  Google Scholar 

  37. Lutz ME. Surgical pearl: curettage before cutaneous surgery to identify an unidentifiable biopsy site. J Am Acad Dermatol. 2002;46:591–593.

    Article  PubMed  Google Scholar 

  38. Robbins P, Sarnoff DS. Where’s the spot? J Dermatol Surg Oncol. 1986;12:1251–1252.

    Google Scholar 

  39. Futoryan T, Grande D. Postoperative wound infection rates in dermatologic surgery. Dermatol Surg. 1995;21:509–514.

    Article  CAS  PubMed  Google Scholar 

  40. Whitaker DC, Grande DJ, Johnson SS. Wound infection rate in dermatologic surgery. J Dermatol Surg Oncol. 1988;14:525–528.

    CAS  PubMed  Google Scholar 

  41. Carmichael AJ, Flanagan PG, Holt PJA, Duerden BI. The occurrence of bacteraemia with skin surgery. Br J Dermatol. 1996;134:120–122.

    Article  CAS  PubMed  Google Scholar 

  42. Mulberry G, Snyder AT, Heilman J, Pyrek J, Stahl J. Evaluation of a waterless, scrubless chlorhexidine gluconate/ethanol surgical scrub for antimicrobial efficacy. Am J Infect Control. 2001;29:377–382.

    Article  Google Scholar 

  43. Gupta C, Czubatyj AM, Briski LE, Malani AK. Comparison of two alcohol-based surgical scrub solutions with an iodine-based scrub brush for presurgical antiseptic effectiveness in a community hospital. J Hosp Infect. 2007;65:65–71.

    Article  CAS  PubMed  Google Scholar 

  44. Rhinehart BM, Murphy ME, Farley MF, Albertini JG. Sterile versus nonsterile gloves during Mohs micrographic surgery: infection rate is not affected. Dermatol Surg. 2006;32:170–176.

    Article  CAS  PubMed  Google Scholar 

  45. Kupres K, Rasmussen SE, Albertini JG. Perforation rates for nonsterile examination gloves in routine dermatologic procedures. Dermatol Surg. 2002;28:388–389.

    Article  PubMed  Google Scholar 

  46. Gross DJ, Jamison Y, Martin K, Fields M, Dinehart SM. Surgical glove perforation in dermatologic surgery. J Dermatol Surg Oncol. 1989;15:1226–1228.

    CAS  PubMed  Google Scholar 

  47. Cohen MD, Do JT, Tahery DP, Moy RL. Efficacy of double gloving as a protection against blood exposure in dermatologic surgery. J Dermatol Surg Oncol. 1992;18:873–874.

    CAS  PubMed  Google Scholar 

  48. Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery: report of the American college of cardiology/American heart association task force on practice guidelines (committee on perioperative cardiovascular evaluation for noncardiac surgery). J Am Coll Cardiol. 1996;27:910–948.

    Google Scholar 

  49. Chipev CC, Simon M. Phenotypic differences between dermal fibroblasts from different body sites determine their responses to tension and TGFbeta1. BMC Dermatol. 2002;2:13.

    Article  PubMed  Google Scholar 

  50. Smack DP, Harrington AC, Dunn C, et al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs. bacitracin ointment: a randomized controlled trial. JAMA. 1996;276:972–977.

    Article  CAS  PubMed  Google Scholar 

  51. Classen CD, Evans RS, Pestotnik SL, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Eng J Med. 1992;326:281–286.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA

    Thomas Stasko MD (Associate Professor of Medicine)

  2. Palm Harbor Dermatology, Mohs Surgeon, Palm Harbor, Mexico, FL, USA

    Amy Ross MD

Authors
  1. Thomas Stasko MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amy Ross MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. One Hermann Museum Circle , Houston, 77004, U.S.A.

    Deborah F. MacFarlane

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Stasko, T., Ross, A. (2009). Optimizing Surgical Outcomes. In: MacFarlane, D.F. (eds) Skin Cancer Management. Springer, New York, NY. https://doi.org/10.1007/978-0-387-88495-0_8

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-88495-0_8

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-88494-3

  • Online ISBN: 978-0-387-88495-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation