Dermatologic surgeryIdentifying and defining complications of dermatologic surgery to be tracked in the American College of Mohs Surgery (ACMS) Registry
Section snippets
Methods
An ACMS National Registry and Outcomes Committee (Table I) was appointed by the ACMS Board of Directors for their recognized expertise as Mohs surgeons. Members of the complication subcommittee were pulled from within the National Registry and Outcomes Committee and membership at large (Table II). Members of the committee were chosen to be representative of the ACMS membership, with private and university physicians, and fellow trainees. The complications subcommittee designed a Delphi process
Results
Sixteen committee members responded with free-text entries. The condensed list can be seen in Table III. Two major and one minor complications were rated as highly relevant after the first round of the Delphi process; 2 major and 8 minor complications were rated as low relevance and excluded from further consideration. Thirteen committee members responded to the second rating round. Two further major and one additional minor complications were rated as highly relevant and recommended for
Discussion
Improving the quality and value of patient care is of utmost importance in the current health care environment, and patient registries are a key component of this effort. National surgical registries have emerged as a valuable resource for assuring patient safety by accurately tracking complications and allowing for the comparison of complication rates among specialties and providers.
Although major complications, such as death and hospitalization, are rare occurrences in dermatologic surgery,19
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Identifying critical quality metrics in Mohs Surgery: A national expert consensus process
2024, Journal of the American Academy of DermatologyPreventing and managing complications in dermatologic surgery: Procedural and postsurgical concerns
2021, Journal of the American Academy of DermatologyCitation Excerpt :At least 1 of the following is also required for diagnosis: 1) purulent drainage from the incision site; 2) organism isolation from a culture of incisional fluid or tissue; 3) tenderness or localized swelling with warmth and erythema; or 4) a clinical diagnosis of SSI by the physician.65 SSI is considered a national performance measure for MMS safety.66 Endogenous host risk factors in dermatologic surgery include diabetes, smoking, a body mass index >25 kg/m2, anatomic site, preoperative contamination, anticoagulation therapy, preoperative hypoalbuminemia, nasal Staphylococcus aureus carriage, and age (risk steadily increases with age).67-73
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2021, Journal of the American Academy of DermatologyCitation Excerpt :AFX is commonly seen in elderly White males on sun-damaged skin of the head and neck.2,3 Recent evidence supports the classification of AFX as a malignancy with metastatic potential.4-8 Histologic diagnosis of AFX is by exclusion, with desmoplastic squamous cell carcinoma, desmoplastic melanoma, and leiomyosarcoma mimicking its microscopic findings.
Perioperative Antibiotic Use in Cutaneous Surgery
2019, Dermatologic ClinicsCitation Excerpt :Larger and randomized controlled studies have been called for. The establishment of national clinical data registries may facilitate future data collection and tracking of SSI.43 No existing guidelines direct appropriate prescription of antibiotics for postoperative SSI prophylaxis in the context of dermatologic surgery.
A 4-year retrospective assessment of postoperative complications in immunosuppressed patients following Mohs micrographic surgery
2019, Journal of the American Academy of DermatologyCitation Excerpt :The types of complications more likely to occur in the immunocompromised group included surgical site infection and wound dehiscence. This is consistent with the results of prior studies showing higher rates of infectious complication following dermatologic surgery among immunocompromised patients, as well as with the well-established literature indicating that subacute infection and impaired wound healing are significant risk factors for wound dehiscence.5-7,17,18 Interestingly, there was only 1 case involving an immunocompetent patient who developed both infection and dehiscence simultaneously; all other reported infections or instances of dehiscence occurred in isolation.
Reconstructive methods in Mohs micrographic surgery in Uruguay: A bidirectional descriptive cohort analysis
2018, Actas Dermo-SifiliograficasCitation Excerpt :Due to the facts previously stated, we believe our samples are not comparable in regards of esthetic results. Surgical registries are useful tools to monitor patient safety.17 Given that only three patients had complications, there is no way of determining statistical significance with such a low number.
Funding sources: None.
Conflicts of interest: None declared.