Khan Samiya, Shih Terri, Shih Shawn, Khachemoune Amor
Long School of Medicine, University of Texas Health Science Center at San Antonio, TX, USA.
David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
Dermatol Pract Concept. 2021 Jan 29;11(1):e2021126. doi: 10.5826/dpc.1101a126. eCollection 2021 Jan.
Dermatologic procedures are performed under varying degrees of antisepsis, and no clear guidelines exist regarding the role of the aseptic technique in dermatology. This review aims to clarify the terminology surrounding surgical asepsis and examines the importance of various components of the aseptic technique in cutaneous surgery. Included are studies examining optimal glove type, surgical instruments, skin antisepsis, and cost-reducing protocols. Our review highlights that most dermatology procedures are not performed under completely sterile conditions due to the lack of environmental and foot traffic controls in dermatology offices. In addition, for some outpatient procedures, such as for minor excisions and Mohs surgery before reconstruction, elements of the clean technique can be used without increasing infection rates. However, data on the feasibility of a clean protocol for Mohs reconstruction is conflicting. Future prospective, randomized trials analyzing various components of the aseptic technique in dermatology are greatly needed so that guidelines can be established for practicing dermatologists.
皮肤科手术在不同程度的消毒条件下进行，关于无菌技术在皮肤科中的作用尚无明确指南。本综述旨在阐明围绕手术无菌的术语，并探讨无菌技术各组成部分在皮肤外科手术中的重要性。其中包括研究最佳手套类型、手术器械、皮肤消毒和降低成本方案。我们的综述强调，由于皮肤科诊所缺乏环境和人员流动控制，大多数皮肤科手术并非在完全无菌的条件下进行。此外，对于一些门诊手术，如小切除和重建前的莫氏手术，可采用清洁技术的要素而不增加感染率。然而，关于莫氏重建清洁方案可行性的数据存在矛盾。未来非常需要进行前瞻性、随机试验，分析皮肤科无菌技术的各个组成部分，以便为皮肤科医生制定指南。
