New Study Documents Outpatient Surgery Safety
NEW YORK, NY (April 29, 2002) — Results of a significant new study on the safety of outpatient plastic surgery will be presented at the Annual Meeting of the American Society for Aesthetic Plastic Surgery (ASAPS), April 27-May 3, in Las Vegas. The study, documenting 5,316 consecutive cases (primarily cosmetic surgery), demonstrates that accredited ambulatory surgery facilities provide patients with a reliably safe alternative to more expensive hospital-based plastic surgery.
Advances in technology and anesthesia monitoring mean that outpatient facilities can now duplicate the type and quality of equipment found in the traditional hospital operating room. As a result, there has been a dramatic increase in the number of outpatient surgery facilities in the United States. Current estimates suggest that four out of every five operative procedures will be performed in outpatient facilities by the year 2005, and that one-quarter of these procedures will be performed in a doctor's office.
The advantages of office-based cosmetic plastic surgery are many, ranging from cost savings to increased convenience and privacy for patients. However, concerns about patient welfare have been raised, with only a few published studies to document the actual safety record of outpatient plastic surgery.
The new study shows that over a six-year period during which seven plastic surgeons performed 5,316 cases in a single facility, the rate of surgical complications (requiring return to operating room) was only 0.6 percent. There were no patient deaths.
According to Rod Rohrich, MD, ASAPS Scientific Program Chair and co-author of the paper, this safety record compares favorably with that of similar surgery performed in the hospital setting. One of the reasons for the low rate of complications, says Dr. Rohrich, was the care taken in patient screening and selection. "The importance of a complete medical history in being able to anticipate and avoid potential problems cannot be overemphasized," he says.
Another key to patient safety, says Dr. Rohrich, was a properly equipped facility. Outpatient facilities that meet national standards for accreditation must have equipment comparable to that found in hospital-based facilities, as well as backup support for vital equipment failures. They must be staffed with qualified anesthesia providers, nurses and board-certified surgeons who have hospital staff privileges to perform the same procedures being performed in the outpatient facility.
A third factor in the low percentage of complications may have been the surgeons' decision to minimize performance of multiple, unrelated surgeries in the same operative session. While some combinations of cosmetic procedures are safely and routinely performed with excellent out-comes, other combinations appear to increase surgical risks. Among the study's more than 5,000 consecutive surgeries, only approximately 10 percent involved multiple, unrelated procedures.
The American Society for Aesthetic Plastic Surgery believes that surgical facility accreditation is important to patient safety. ASAPS will require its members, as of July 2002, to perform all surgery (except those cases requiring only minor local anesthesia and/or mini-mum oral or intramuscular tranquilization) in facilities that meet at least one of the following criteria: 1) accredited by a national or state recognized accrediting agency/organization; 2) certified to participate in the Medicare program under Title XVIII; or 3) state licensed.
"The documentation of such a high level of safety over a long period of time in an accredited outpatient facility confirms that the standards mandated by the recognized accrediting agencies, as well as good judgment by experienced and qualified plastic surgeons, do result in safe outcomes for patients," says ASAPS President Malcolm Paul, MD.
This presentation is scheduled for Thursday, May 2, 6:00 pm PDT.
ROD ROHRICH, MD, is available for interviews.
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The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body. ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.
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