Reappraising Elements of the Aseptic Technique in Dermatology: A Review

Samiya Khan; Terri Shih; Shawn Shih; Amor Khachemoune

doi:10.5826/dpc.1101a126

Reappraising Elements of the Aseptic Technique in Dermatology: A Review

Authors

Samiya Khan Long School of Medicine, University of Texas Health Science Center at San Antonio, TX, USA
Terri Shih David Geffen School of Medicine at University of California, Los Angeles, CA, USA
Shawn Shih University of Central Florida College of Medicine, Orlando, FL, USA
Amor Khachemoune Department of Dermatology, SUNY Downstate & Veterans Affairs Medical Center, Brooklyn, NY, USA

Keywords:

gloves, sterilization, wound infection, Mohs surgery, skin neoplasms

Abstract

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.

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