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- Presentation
Tips for a Better Surgical Experience for Patients and Surgeons
Description
The speaker shares practical tips for making surgery better for both patients and surgeons. For patients, he emphasizes reducing stress because it can impair wound healing, preparing them in advance with consultations and nurse calls, minimizing pain with careful local anesthesia techniques and non-opioid pain control, and improving comfort with warm blankets, music, snacks, wound care kits, and follow-up calls. For surgeons, he stresses staying comfortable, protecting the eyes, handling sharps safely, using blade removal tools and magnetic or foam sharps holders, and ensuring good smoke evacuation, lighting, magnification, and suction. He also discusses suturing and closure strategies, favoring strong deep sutures, fast-absorbing materials when appropriate, careful margin assessment with curettage, choosing simple primary closure when possible, and using alternatives like purse-string techniques, small grafts, granulation, and low-cost dermabrasion paper for finishing scars or grafts.
View moreConclusions
- Reducing stress and maximizing patient comfort are presented as important because they may improve wound healing and overall surgical experience.
- Preparing patients in advance with education, consultation, and pre-op calls can reduce anxiety and make surgery go more smoothly.
- Simple comfort measures such as warm blankets, music, snacks, and a free wound-care kit are said to meaningfully improve patient satisfaction.
- Postoperative follow-up calls help patients feel cared for and supported after surgery.
- Surgeons should also optimize their own experience by using good lighting, maintaining comfort, and working with a capable assistant.
- Eye protection, safe sharps handling, and smoke evacuation are emphasized as essential practices for surgeon safety.
- Good visualization tools such as overhead lights and magnification are framed as necessary for better surgical performance.
- Suction is important for controlling bleeding so the surgeon can see clearly and work effectively.
- Careful closure technique can often avoid the need for more complex reconstruction.
- Strong deep sutures, along with Dermabond, Steri-Strips, Monocryl, or rapidly absorbing sutures, can often achieve good results with less follow-up burden.
- Fast-absorbing gut is presented as especially useful for children, elderly patients, grafts, and patients unlikely to return for suture removal.
- Using a curette before excision can help define tumor margins and depth, particularly in Mohs and skin cancer surgery.
- Incising in a circular shape, undermining, and removing dog ears can make closure easier when tissue tension or relaxed skin tension lines are uncertain.
- Primary closure should be used whenever possible because many defects can be closed simply without a flap.
- Purse-string closure, Burrow’s grafts, and selective granulation are useful alternatives when primary closure is not ideal.
- Simple improvised dermabrasion materials, such as sterilized sanding paper, can be effective for spot dermabrasion and scar or graft refinement.
- Marc Brown, M.D., professor of dermatology and oncology, director of the Division of Mohs Surgery and Cutaneous Oncology at the University of Rochester Medical Center in Rochester, New York.
- Mohs Micrographic Surgery
- Frank Lambert, MD
- MoM Surgery