Archive January 2004 V, No. 1

8 Tips for Improving Office Surgery Safety

Here's advice on how to make office surgery safer for your patients.

Dianne Taylor, Contributing Editor

BIO

Sometimes, complications are unavoidable during surgery. Other times, problems can cascade into serious events because staff are unqualified or unprepared, equipment malfunctions or recovering patients go unattended. To help prevent problems in the office setting, surgeons offer this advice.

Don't take every case
"The No. 1 thing: Turn down cases you shouldn't do," says Max Gouverne, MD, a plastic surgeon in Aesthetic Associates in Corpus Christi, Texas. Dr. Gouverne won't do combined procedures, such as abdominoplasty and liposuction, on a patient with a high body mass index in his office suite. "The complication rates for combined procedures is more than the simple sum of the complication rates for each," he says.

Some argue no hard clinical data supports this observation, but there is little doubt combined procedures are riskier, says Ronald E. Iverson, MD, FACS, past president of the American Association for Ac-creditation of Ambulatory Sur-gery Facilities (AAAASF). Add-ing liposuction to abdominoplasty, for example, may compromise blood flow to the surgical area. Combined procedures can also increase blood loss and fluid and electrolyte shifting. Prolonged surgery stresses patients physiologically, especially those with pre-existing risk factors, and combined procedures can increase pain and lengthen recovery.

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