Avoiding Medical Errors in Cutaneous Site Identification: A Best Practices Review

Dermatol Surg. 2016 Apr;42(4):477-84. doi: 10.1097/DSS.0000000000000683.

Abstract

Background: Although the field of dermatology has a relatively low incidence of medical errors, dermatologic surgery is a major area where medical errors occur.

Objective: The purpose of this article is to catalog the many cutaneous site identification techniques used by practitioners and determine which techniques are most evidence based.

Materials and methods: A comprehensive literature review of cutaneous surgical site identification techniques and medical errors in dermatology.

Results: Wrong-site surgery often occurs because of an inability to identify the surgical site because of factors such as inadequate documentation from referring physicians, well-healed scars obscuring the biopsy site, and a patient's inability to visualize the surgical site. Practitioners use techniques such as photography, dermabrasion, written descriptions using anatomic landmarks, and site identification protocols for surgical site identification.

Conclusion: Site identification remains a challenge for dermatologists and is a leading cause of medical errors in this field. Patients are often unreliable in their ability to identify biopsy sites; therefore, practitioners must take a proactive role to ensure that medical errors do not occur. This article provides a thorough description and evaluation of current site identification techniques used in dermatology with the aim to improve quality of care and reduce medical errors.

Publication types

  • Review

MeSH terms

  • Benchmarking*
  • Dermatologic Surgical Procedures / standards*
  • Humans
  • Medical Errors / prevention & control*
  • Preoperative Care
  • Skin Diseases / pathology
  • Skin Diseases / surgery