Dermatologic Surgery最新文献

Background: Health care resource use, pollution, and greenhouse gas emissions are increasingly studied to balance quality patient care with environmental, social, and financial impacts. However, consolidated sustainability recommendations for Mohs micrographic surgery (MMS) remain unexplored.

Objective: To assess current recommendations and studies on environmental sustainability in MMS.

Materials and methods: Following PRISMA-ScR guidelines, a literature review was conducted across PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane databases from 2014 to 2024. English peer-reviewed studies using keywords "climate change," "margin control," "environment," "sustainability," "waste," "resource," "Mohs micrographic," "Mohs," and "micrographic" were included. Duplicates and conference abstracts were excluded.

Results: Of 5,526 articles, nine met inclusion criteria after independent review. Recommendations included standardized surgical sets, limiting instruments to essentials, and redesigning procedure rooms to improve recycling access. Three articles found no significant difference in infection rates between sterile and nonsterile glove use. Other suggestions involved recycling plastics, using microtubules to reduce chromacoding dye waste by minimizing spillage and drying, and scheduling virtual preoperative visits to reduce travel emissions. Insurance reimbursement for virtual visits remains a limitation.

Conclusion: Restructuring surgical protocols and procedure room design encourages innovation and addresses workflow inefficiencies rooted in tradition rather than evidence, promoting sustainability in MMS.

Background: Accurate description of biopsy sites is critical to prevent wrong-site procedures, which carry serious patient safety and medicolegal consequences. Despite existing guidelines, insufficient site documentation remains a persistent challenge.

Objective: Identify factors associated with incorrect anatomical site descriptions in dermatologic surgery referrals.

Materials and methods: Prospective, observational cohort of 1,000 consecutive referrals for surgery at a single private dermatologic surgery practice was assessed for correct anatomical site description, defined as concordance between documented biopsy location and the clinically evident lesion or scar at the time of surgery. Referral documentation was assessed for clinical photographs, anatomical diagrams, age, sex, tumor type, tumor location, lesion size, and referring provider type.

Results: Anatomical location significantly influenced correctness (χ2 = 22.47, p = .002), with nasal lesions more likely to be incorrectly described (residual = -3.64). Referrals including a clinical photograph (χ2 = 4.14, p = .042) or an anatomical diagram (χ2 = 12.33, p < .001) were significantly more likely to be correctly described, however, only 67.1% of referrals included a photograph and 53.9% included an anatomical diagram. Moreover, 100% of referrals that included triangulation were correctly described.

Conclusion: These findings highlight areas for targeted intervention to improve referral documentation.

Background: Platelet-rich plasma (PRP) is widely used in regenerative medicine due to its high concentration of platelets and growth factors that promote tissue repair and angiogenesis. In hair transplantation, PRP has mainly been studied as an adjunct for hair growth, whereas its effect on donor-area wound healing after follicular unit excision (FUE) remains insufficiently documented.

Objective: To evaluate the effect of PRP on donor-area wound healing, after FUE harvesting.

Methods: Nineteen healthy male patients aged 30 to 59 years with no prior hair transplantation were enrolled. Two equal 1 cm2 areas were marked in the occipital donor region. Follicular units were harvested using a 1.1-mm sharp motorized punch. One area received an intradermal injection of 0.1-mL PRP prepared by single-spin centrifugation at 3,500 rpm for 12 minutes, whereas the contralateral area served as control. Wound surface areas were assessed immediately and 24 hours postharvesting, using image analysis. Statistical analysis was performed on 49 wounds.

Results: After 24 hours, mean wound surface reduction was 21.3% in the control group and 49.95% in the PRP-treated group (p < .001).

Conclusion: PRP significantly accelerates donor-area wound healing after FUE harvesting.