학술논문

Dispelling myths in dermatologic surgery
Document Type
Academic Journal
Source
Acta Dermatovenerologica Alpina, Pannonica et Adriatica. July, 2019, Vol. 28 Issue 3, p113, 5 p.
Subject
Apixaban -- Usage -- Health aspects
Surgery -- Health aspects
Evidence-based medicine -- Health aspects
Anti-infective agents -- Usage -- Health aspects
Platelet aggregation inhibitors -- Usage -- Health aspects
Epinephrine -- Health aspects
Dermatologic agents -- Usage -- Health aspects
Infection -- Prevention -- Care and treatment -- Risk factors -- Health aspects
Rivaroxaban -- Health aspects
Retinoids -- Usage -- Health aspects
Prophylaxis
Ticagrelor
Wounds
Anticoagulants
Prasugrel
Anesthesia
Clopidogrel
Adrenergic agonists
Language
English
ISSN
1318-4458
Abstract
Several common practices and widely accepted principles implemented in dermatologic surgery are based on perpetuated beliefs not supported by evidence-based medicine. After evaluating the validity of misconceptions in dermatologic surgery, updated recommendations include restriction of antibiotic prophylaxis to patient-specific risk factors, continuation of anticoagulant therapy perioperatively, safe use of epinephrine for digital anesthesia, clean technique as an efficacious substitute for sterile, topical emollients and petroleum instead of antimicrobials to prevent surgical site infection, alternatives to elliptical excisions for decreasing scar length, wound eversion for areas of greater cosmetic concern, and cessation of systemic retinoids as an unnecessary prerequisite for most cutaneous procedures. Surgical procedures in dermatology are not as conducive to extensive validation studies, leading to the propagation of myths based on anecdotal evidence. Although current reports in the literature discredit several misconceptions, well-designed and adequately powered randomized studies are needed to verify optimal procedural guidelines. Keywords: dermatologic surgery, myths, antibiotic prophylaxis, digital anesthesia, sterile technique, surgical site infection
Introduction Numerous practices in dermatologic surgery are deep-seated, based on experience and accepted beliefs that are not supported by evidence-based medicine. Although medications undergo extensive trials required by the Food [...]