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THE SURGICAL SETTING

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SUMMARY

  • A well-equipped, well-designed surgical suite improves the surgical experience for the patient as well as the dermatologic surgeon and maximizes patient safety.

  • Dermatologic surgeons have historically operated in an array of surgical settings, including hospital operating rooms, outpatient ambulatory surgical centers (ASCs), and office-based surgical suites.

  • The surgical suite or operating room needs to be well lit, well ventilated, and include ample floor space for an electric operating table, emergency equipment, Mayo stand(s), instrument storage, electrosurgical equipment, and sink.

image Beginner Pearls

  • Multiple electrical outlets in the surgical suite are very helpful.

  • The surgical table should ideally be located at the center of the room. While a wider table may be more comfortable for larger patients, a narrow table allows the dermatologic surgeon to access the surgical site more easily and maintain good ergonomic posture.

image Expert Pearls

  • Eyeglass-mounted LED lights provide direct illumination for the surgical field and are increasingly becoming the norm as long-lasting battery packs coupled with a decreased price point make these the illumination technique of choice for many surgeons.

  • Interior design features such as outdoor photographs, spacious rooms, and architectural window features providing more sunlight have positive effects on perceived anxiety and postoperative pain.

  • Aesthetically pleasing healing environments can have a positive influence on patients, and many authors recommend the purposeful use of architecture, art, and music to improve the surgical experience for the patient.

  • Since surgical rooms are often kept at a cooler temperature than other offices (given the heat generated by lighting, surgical gowns, and other equipment), for patients’ comfort, extra blankets and pillows may be made available.

image Don’t Forget!

  • Ergonomic approaches to minimizing injury risk for the surgeon include modifying footwear, flooring, surgical instruments, operating position, lighting, and table height.

  • When designing and building a dermatologic surgery suite, it is important to consider future growth.

image Pitfalls and Cautions

  • Erring on the side of larger operating rooms with abundant storage permits future expansion and flexibility.

  • State and federal laws govern medical waste disposal.

  • Multiple surveys of Mohs surgeons found that over 90% of respondents experienced symptoms exacerbated by surgery including stiffness and pain of the neck, shoulders, and lower back, as well as headaches.

INTRODUCTION

Dermatologic surgery encompasses a broad range of procedural complexity, from standard procedures such as biopsies, electrosurgery, sclerotherapy, soft-tissue augmentation, and toxin/filler injections to more aggressive surgical procedures such as skin cancer excisions, Mohs surgery, complex reconstruction, laser resurfacing, liposuction, and hair restoration.

It is important that the dermatologist practice with skill in a well-equipped, well-designed surgical suite that improves the surgical experience for the patient as well as the dermatologic surgeon, and—most importantly—maximizes patient safety. Dermatologic surgeons have historically operated in an array of surgical settings, including hospital operating rooms, outpatient ambulatory surgical centers (ASCs), and office-based surgical ...

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