Skip to main content
SpringerLink
Log in

Prevention of Surgical Complications

  • Chapter
  • First Online:
Preventive Dermatology

  • 1210 Accesses

Abstract

One of the defining characteristics of dermatology is wide array of procedures that are performed on the skin. Whether for diagnostic or treatment purposes, dermatologic procedures are an important constituent contributing to the personality of this specialty. Dermatologic surgery is one of the most important of these procedures and although not common, adverse events can result, which are troublesome both for the patient and the physician. An appropriate knowledge of how to prevent such undesirable occurrences is mandatory for any physician wishing to engage in dermatologic surgery. It is hoped that this chapter will contribute to this important body of knowledge.

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 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover 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

Similar content being viewed by others

References

  1. Stasko T, Henghold WB. Complications in cutaneous procedures. In: Roenigk RK, Ratz JL, Roenigk HH Jr, eds. Roenigk’s Dermatologic Surgery: Current Techniques in Procedural Dermatology. 3rd ed. New York: Informa Healthcare; 2007

    Google Scholar 

  2. Mukamal KJ, Massaro JM, Ault KA, et al Alcohol consumption and platelet activation and aggregation among women and men: the Framingham offspring study alcoholism. Alcohol Clin Exp Res. 2005;29(10):1906–1912

    Article  PubMed  CAS  Google Scholar 

  3. Baldassarre D, Amato M, Eligini S, et al Effect of n-3 fatty acids on carotid atherosclerosis and haemostasis in patients with combined hyperlipoproteinemia: a double-blind pilot study in primary prevention. Ann Med. 2006;38(5):367–375

    Article  PubMed  CAS  Google Scholar 

  4. Furst DE, Ulrich RW. Nonsteroidal antiinflammatory drugs, disease-modifying antirheumatic drugs, nonopioid analgesics, and drugs used in gout. In: Katzung BG, ed. Basic and Clinical Pharmacology. 10th ed. New York: McGraw Hill Medical; 2007

    Google Scholar 

  5. Wickersham RM, Novak KK, eds. Drug Facts and Comparisons 2008. St. Louis, MO: Wolters Kluwer Health; 2007

    Google Scholar 

  6. Alcalay J, Alkalay R. Controversies in perioperative management of blood thinners in dermatologic surgery: continue or discontinue? Dermatol Surg. 2004;30(8):1091–1094

    Article  PubMed  Google Scholar 

  7. Otley CC. Continuation of medically necessary aspirin and warfarin during cutaneous surgery. Mayo Clin Proc. 2003; 78(11):1392–1396

    Article  PubMed  Google Scholar 

  8. Shimizu I, Jellinek NJ, Dufresne RG, et al Multiple antithrombotic agents increase the risk of postoperative hemorrhage in dermatologic surgery. J Am Acad Dermatol. 2008; 58(5):810–816

    Article  PubMed  Google Scholar 

  9. Kirkorian AY, Moore BL, Siskind J, Marmur ES. Perioperative management of anticoagulant therapy during cutaneous surgery: 2005 survey of Mohs surgeons. Dermatol Surg. 2007;33(10):1189–1197

    Article  PubMed  CAS  Google Scholar 

  10. Ah-Weng A, Natarajan S, Velangi S, Langtry JA. Preoperative monitoring of warfarin in cutaneous surgery. Br J Dermatol. 2003;149(2):386–389

    Article  PubMed  CAS  Google Scholar 

  11. Leonard AL, Hanke CW, Greist A. Perioperative management of von Willebrand disease in dermatologic surgery. Dermatol Surg. 2007;33(4):403–409

    Article  PubMed  CAS  Google Scholar 

  12. Peterson SR, Joseph AK. Inherited bleeding disorders in dermatologic surgery. Dermatol Surg. 2001;27(10):885–889

    Article  PubMed  CAS  Google Scholar 

  13. Koay J, Orengo I. Application of local anesthetics in dermatologic surgery. Dermatol Surg. 2002;28(2):143–148

    Article  PubMed  Google Scholar 

  14. Ho J, Hruza G. Hydrophilic polymers with potassium salt and microporous polysaccharides for use as hemostatic agents. Dermatol Surg. 2007;33(12):1430–1433

    PubMed  CAS  Google Scholar 

  15. Cohen SN, Sidebottom AJ, Varma S. Intraoral hematoma: a novel complication of dermatologic surgery. Dermatol Surg. 2007;33(9):1139–1141

    Article  PubMed  CAS  Google Scholar 

  16. Maragh SL, Brown MD. Prospective evaluation of surgical site infection rate among patients with Mohs micrographic surgery without the use of prophylactic antibiotics. J Am Acad Dermatol. 2008;59(2):275–278

    Article  PubMed  Google Scholar 

  17. Maragh SL, Otley CC, Roenigk RK, Phillips PK. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg. 2005;31(1):91-93

    Google Scholar 

  18. Rogues AM, Lasheras A, Amici JM, et al. Infection control practices and infectious complications in dermatological surgery. J Hosp Infect. 2007;65(3):258–263

    Article  PubMed  CAS  Google Scholar 

  19. Rhinehart MB, Murphy MM, Farley MF, et al. Sterile versus nonsterile gloves during Mohs micrographic surgery: infection rate is not affected. Dermatol Surg. 2006;32(6):819–826

    Article  Google Scholar 

  20. Wright TI, Baddour LM, Berbari EF, et al. Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008. J Am Acad Dermatol. 2008;59(3):464–473

    Article  PubMed  Google Scholar 

  21. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116(15):1736–1754

    Article  PubMed  Google Scholar 

  22. American Academy of Orthopaedic Surgeons. Dental Work After a Joint Replacement. At: http://orthoinfo.aaos.org/topic.cfm?topic=A00226; 2007 Accessed 12.12.07

  23. American Academy of Orthopaedic Surgeons. Your Joint Replacement: Urological Procedures and Antibiotics. At: http://orthoinfo.aaos.org/topic.cfm?topic=A00383; 2007 Accessed 12.12.07

  24. Messingham MJ, Arpey CJ. Update on the use of antibiotics in cutaneous surgery. Dermatol Surg. 2005;31(8 Pt 2):1068–1078

    PubMed  CAS  Google Scholar 

  25. Ritter MA, French ML, Eitzen HE, Gioe TJ. The antimicrobial effectiveness of operative-site preparative agents: a microbiological and clinical study. J Bone Joint Surg Am. 1980;62:826–828

    PubMed  CAS  Google Scholar 

  26. Balin AK, Pratt L. Dilute povidone-iodine solutions inhibit human skin fibroblast growth. Dermatol Surg. 2002;28(3): 210–214

    Article  PubMed  Google Scholar 

  27. Jacob SE, Amado A, Cohen DE. Dermatologic surgical implications of allergic contact dermatitis. Dermatol Surg. 2005;31(9 Pt 1):1116–1123

    PubMed  CAS  Google Scholar 

  28. Garibaldi RA, Skolnick D, Lerer T, et al. The impact of preoperative skin disinfection on preventing intraoperative wound contamination. Infect Control Hosp Epidemiol. 1988;9(3):109–113

    Article  PubMed  CAS  Google Scholar 

  29. Spann CT, Taylor S, Weinberg J. Topical antimicrobial agents in dermatology. Dis Mon. 2004;50(7):407–421

    Article  PubMed  Google Scholar 

  30. Varley GA, Meisler DM, Benes SC, et al. Hibiclens keratopathy. A clinicopathologic case report. Cornea. 1990;9(4): 341–346

    Article  PubMed  CAS  Google Scholar 

  31. Perez R, Freeman S, Sohmer H, Sichel JY. Vestibular and cochlear ototoxicity of topical antiseptics assessed by evoked potentials. Laryngoscope. 2000;110(9):1522–1527

    Article  PubMed  CAS  Google Scholar 

  32. Igarashi Y, Oka Y. Vestibular ototoxicity following intratympanic applications of chlorhexidine gluconate in the cat. Arch Otorhinolaryngol. 1988;245(4):210–217

    Article  PubMed  CAS  Google Scholar 

  33. Spann CT, Tutrone WD, Weinberg JM, et al. Topical antibacterial agents for wound care: a primer. Dermatol Surg. 2003;29(6):620–626

    Article  PubMed  Google Scholar 

  34. Mayo Clinic. Top Ten Contact Dermatitis Allergens Identified in Mayo Clinic Study. At: http://www.mayoclinic.org/news2006-rst/3268.html; 2007 Accessed 12.12.07

  35. Bernstein SC, Roenigk RK. Surgical pearl: erythromycin ointment for topical antibiotic wound care. J Am Acad Dermatol. 1995;32:659–660

    Article  PubMed  CAS  Google Scholar 

  36. Orange A, van der Wouden J, Konig S, et al. Retapamulin ointment for the treatment of impetigo in adults and children: results of a phase III, placebo-controlled, double-blind trial. J Am Acad Dermatol. 2007;56(suppl 2):AB4

    Google Scholar 

  37. Smack DP, Harrington AC, Dunn C, et al. Infection and allergy incidence in ambulatory surgery patients using a white petrolatum vs bacitracin ointment: a randomized controlled trial. JAMA. 1996;276(12):972–977

    Article  PubMed  CAS  Google Scholar 

  38. James WD. Use of antibiotic-containing ointment versus plain petrolatum during and after clean cutaneous surgery. J Am Acad Dermatol. 2006;55(5):915–916

    Article  PubMed  Google Scholar 

  39. Campbell RM, Perlis CS, Fisher E, Gloster HM Jr. Gentamicin ointment versus petrolatum for management of auricular wounds. Dermatol Surg. 2005;31(6):664–669

    Article  PubMed  CAS  Google Scholar 

  40. Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296:1858–1866

    Article  PubMed  CAS  Google Scholar 

  41. Billingsley E. The Role of Antibiotics in Cutaneous Surgery. Emedicine Oct 14, 2006. At: http://www.emedicine.com/derm/topic821.htm; 2007 Accessed 18.12.07

  42. Dodek P, Phillips P. Questionable history of immediate-type hypersensitivity to penicillin in staphylococcal endocarditis: treatment based on skin-test results versus empirical alternative treatment – a decision analysis. Clin Infect Dis. 1999;29(5):1251–1256

    Article  PubMed  CAS  Google Scholar 

  43. Pichichero ME. Cephalosporins can be prescribed safely for penicillin-allergic patients. J Fam Pract. 2006;55(2): 106–112

    PubMed  Google Scholar 

  44. Adachi A, Fukunaga A, Hayashi K, et al. Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone-iodine. Contact Derm. 2003;48(3):133–136

    Article  PubMed  Google Scholar 

  45. Berkun Y, Ben-Zvi A, Levy Y, et al. Evaluation of adverse reactions to local anesthetics: experience with 236 patients. Ann Allergy Asthma Immunol. 2003;91(4):342–345

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  47. Fader DJ, Johnson TM. Medical issues and emergencies in the dermatology office. J Am Acad Dermatol. 1997;36(1): 1–16

    Article  PubMed  CAS  Google Scholar 

  48. The American Academy of Dermatology Joint AAD/ASDS Liaison Committee. Current issues in dermatologic office-based surgery. The American Academy of Dermatology Joint AAD/ASDS Liaison Committee. Dermatol Surg. 1999; 25(10):806–815

    Google Scholar 

  49. Warshaw EM, Ahmed RL, Belsito DV, et al. North American Contact Dermatitis Group. Contact dermatitis of the hands: cross-sectional analyses of North American Contact Dermatitis Group data, 1994–2004. J Am Acad Dermatol. 2007;57(2):301–314

    Article  PubMed  Google Scholar 

  50. American Academy of Dermatology. What is a Scar. At: http://www.aad.org/public/Publications/pamphlets/WhatisaScar.htm; 2007 Accessed 12.12.07

  51. Due E, Rossen K, Sorensen LT, et al. Effect of UV irradiation on cutaneous cicatrices: a randomized, controlled trial with clinical, skin reflectance, histological, immunohistochemical and biochemical evaluations. Acta Derm Venereol. 2007;87(1):27–32

    Article  PubMed  CAS  Google Scholar 

  52. Wahie S, Lawrence CM. Wound complications following diagnostic skin biopsies in dermatology inpatients. Arch Dermatol. 2007;143(10):1267–1271

    Article  PubMed  Google Scholar 

  53. Adams DC, Ramsey ML. Grafts in dermatologic surgery: review and update on full- and split-thickness skin grafts, free cartilage grafts, and composite grafts. Dermatol Surg. 2005;31(8 Pt 2):1055–1067

    PubMed  CAS  Google Scholar 

  54. Lazareth I, Hubert S, Michon-Pasturel U, Priollet P. Vitamin C deficiency and leg ulcers. A case control study. J Mal Vasc. 2007;32(2):96–99

    Article  PubMed  CAS  Google Scholar 

  55. Rojas AI, Phillips TJ. Patients with chronic leg ulcers show diminished levels of vitamins A and E, carotenes, and zinc. Dermatol Surg. 1999;25(8):601–604

    Article  PubMed  CAS  Google Scholar 

  56. Wicke C, Halliday B, Allen D, et al. Effects of steroids and retinoids on wound healing. Arch Surg. 2000;135:1265–1270

    Article  PubMed  CAS  Google Scholar 

  57. Dostal GH, Gamelli RL. The differential effect of corticosteroids on wound disruption strength in mice. Arch Surg. 1990;125(5):636–640

    Article  PubMed  CAS  Google Scholar 

  58. Gordon AJ, Olstein J, Conigliaro J. Identification and treatment of alcohol use disorders in the perioperative period. Postgrad Med. 2006;119(2):46–55

    Article  PubMed  Google Scholar 

  59. Kiecolt-Glaser JK, Loving TJ, Stowell JR, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing. Arch Gen Psychiatry. 2005;2(12):1377–1384

    Article  Google Scholar 

  60. Glaser R, Kiecolt-Glaser JK, Marucha PT, et al. Stress-related changes in proinflammatory cytokine production in wounds. Arch Gen Psychiatry. 1999;56(5):450–456

    Article  PubMed  CAS  Google Scholar 

  61. Chen MA, Davidson TM. Scar management: prevention and treatment strategies. Curr Opin Otolaryngol Head Neck Surg. 2005;13(4):242–247

    Article  PubMed  Google Scholar 

  62. Zitelli JA. Wound healing by second intention. In: Roenigk RK, Ratz JL, Roenigk HH Jr, eds. Roenigk’s Dermatologic Surgery: Current Techniques in Procedural Dermatology. 3rd ed. New York: Informa Healthcare; 2007

    Google Scholar 

  63. Orengo I, Iyengar V. Anatomy in cutaneous surgery. Emedicine. December 15, 2006. At: http://www.emedicine.com/derm/topic820.htm; 2007 Accessed 12.12.07

  64. Berman B, Flores F. Comparison of a silicone gel-filled cushion and silicon gel sheeting for the treatment of hypertrophic or keloid scars. Dermatol Surg. 1999;25(6):484–486

    Article  PubMed  CAS  Google Scholar 

  65. Chung VQ, Kelley L, Marra D, Jiang SB. Onion extract gel versus petrolatum emollient on new surgical scars: a prospective double-blinded study. Dermatol Surg. 2006;32(2):193–197

    Article  PubMed  CAS  Google Scholar 

  66. Berman B, Perez OA, Konda S, et al. A review of the biologic effects, clinical efficacy, and safety of silicone elastomer sheeting for hypertrophic and keloid scar treatment and management. Dermatol Surg. 2007;33(11):1291–1302

    Article  PubMed  CAS  Google Scholar 

  67. Chang CC, Kuo YF, Chiu HC, et al. Hydration, not silicone, modulates the effects of keratinocytes on fibroblasts. J Surg Res. 1995;59:705–711

    Article  PubMed  CAS  Google Scholar 

  68. Zurada JM, Kriegel D, Davis IC. Topical treatments for hypertrophic scars. J Am Acad Dermatol. 2006;55(6):1024–1031

    Article  PubMed  Google Scholar 

  69. Weisberg NK, Nehal KS, Zide BM. Dog-ears: a review. Dermatol Surg. 2000;26(4):363–370

    Article  PubMed  CAS  Google Scholar 

  70. Lee KS, Kim NG, Jang PY, et al. Statistical analysis of surgical dog-ear regression. Dermatol Surg. 2008;34(8): 1070–1076

    Article  PubMed  CAS  Google Scholar 

  71. Robinson JK. The eye and eyelid. In: Roenigk RK, Ratz JL, Roenigk HH Jr, eds. Roenigk’s Dermatologic Surgery: Current Techniques in Procedural Dermatology. 3rd ed. New York: Informa Healthcare; 2007

    Google Scholar 

  72. Revis DR, Seagle MB. Local anesthetics. Emedicine. October 26, 2005. At: http://www.emedicine.com/ent/topic20.htm; 2007 Accessed 12.12.07

  73. Zamanian RT, Olsson JK, Ginther B. Toxicity, local anesthetics. Emedicine. June 20, 2005. At: http://www.emedicine.com/emerg/topic761.htm; 2007 Accessed 12.12.07

  74. Peralta R, Bastings E, Guzofski S. Toxicity, Lidocaine. April 25, 2007. Emedicine. At: http://www.emedicine.com/med/topic1297.htm; 2007 Accessed 12.12.07

  75. Cox B, Durieux ME, Marcus MA. Toxicity of local anaesthetics. Best Pract Res Clin Anaesthesiol. 2003;17(1): 111–136

    Article  PubMed  CAS  Google Scholar 

  76. Stasko S, Clayton AS. Surgical complications and optimizing outcomes. In: Bolognia JL, Jorizzo JL, Rapini RP, eds. Dermatology. New York: Mosby; 2003

    Google Scholar 

  77. Fisher DA. A simple method of identifying the spinal accessory nerve. Dermatol Surg. 2000;26(4):384–386

    Article  PubMed  CAS  Google Scholar 

  78. Alam M, Goldberg LH. Two-lobed advancement flap for cutaneous helical rim defects. Dermatol Surg. 2003;29(10): 1044–1049

    Article  PubMed  Google Scholar 

  79. See A, Smith HR. Partially buried horizontal mattress suture: modification of the Haneke-Marini suture. Dermatol Surg. 2004;30(12 Pt 1):1491–1492

    Article  PubMed  Google Scholar 

  80. 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(4):385–390

    Article  PubMed  CAS  Google Scholar 

  81. Matzke TJ, Christenson LJ, Christenson SD, et al. Pacemakers and implantable cardiac defibrillators in dermatologic surgery. Dermatol Surg. 2006;32(9):1155–1162

    Article  PubMed  CAS  Google Scholar 

  82. Koranda FC, Webster RC. Trapdoor effect in nasolabial flaps. Causes and corrections. Arch Otolaryngol. 1985;111(7): 421–424

    Article  PubMed  CAS  Google Scholar 

  83. Fader DJ, Johnson TM. Ear reconstruction utilizing the subcutaneous island pedicle graft (flip-flop) flap. Dermatol Surg. 1999;25(2):94–96

    Article  PubMed  CAS  Google Scholar 

  84. Albertini JG. Regarding the modified Burow’s wedge flap for upper lateral lip defects. Dermatol Surg. 2000;26(10): 981–982

    Article  PubMed  CAS  Google Scholar 

  85. Dinehart SM. The rhombic bilobed flap for nasal reconstruction. Dermatol Surg. 2001;27(5):501–504

    Article  PubMed  CAS  Google Scholar 

  86. Zitelli JA. The bilobed flap for nasal reconstruction. Arch Dermatol. 1989;125:957–959

    Article  PubMed  CAS  Google Scholar 

  87. Goldminz D, Bennett RG. Cigarette smoking and flap and full-thickness graft necrosis. Arch Dermatol. 1991;127: 1012–1015

    Article  PubMed  CAS  Google Scholar 

  88. Dixon AJ, Dixon MP. Reducing opposed multilobed flap repair, a new technique for managing medium-sized low-leg defects following skin cancer surgery. Dermatol Surg. 2004;30(11):1406–1411

    Article  PubMed  Google Scholar 

  89. Cook JL, Perone JB. A prospective evaluation of the incidence of complications associated with Mohs micrographic surgery. Arch Dermatol. 2003;139(2):143–152

    Article  PubMed  Google Scholar 

  90. Amici JM, Rogues AM, Lasheras A, et al. A prospective study of the incidence of complications associated with dermatological surgery. Br J Dermatol. 2005;153(5):967–971

    Article  PubMed  CAS  Google Scholar 

  91. Colon VF. 10 ways to reduce medical malpractice exposure – doctors, lawyers and lawsuits. Physician Executive March, 2002. At: http://findarticles.com/p/articles/mi_m0843/is_2_28/ai_84236558/pg_1; 2007 Accessed 12.12.07

  92. Rice B. 10 ways to guarantee a lawsuit: medical mishaps are only part of the malpractice story. Here’s how to prevent the nonclinical errors that get doctors in legal trouble. Medical Economics Jul 8, 2005. At: http://www.memag.com/memag/article/articleDetail.jsp?id=168737&sk=&date=&%0A%09%09%09&pageID=3; 2007 Accessed 12.12.07

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA

    Michael R. Hinckley

Authors
  1. Michael R. Hinckley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael R. Hinckley .

Editor information

Editors and Affiliations

  1. West Waters Ave. 7902, Tampa, 33615, USA

    Robert Norman

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag London

About this chapter

Cite this chapter

Hinckley, M.R. (2011). Prevention of Surgical Complications. In: Norman, R. (eds) Preventive Dermatology. Springer, London. https://doi.org/10.1007/978-1-84996-021-2_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-84996-021-2_23

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-020-5

  • Online ISBN: 978-1-84996-021-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation