The preoperative consultation and evaluation is important interaction between the patient and the physician. This process allows the surgeon to carefully assess the medical condition, evaluate the patients overall health status, determine risk factors against the procedure, educate the patient, and discuss the procedure in detail. In return, the patient should gain a realistic understanding of the proposed surgery, consider alternative treatment options, and realize the possible complications during the preoperative period. The additional time invested in a preoperative evaluation yields an improved patient physician relationship and reduces surgical complications.
The preoperative management of a patient with a surgical problems involves a diagnostic workup, a preoperative evaluation, and the preoperative preparation. The diagnostic workup determines the cause and the extent of the patient’s condition. The preoperative evaluation is an overall assessment of the patient’s health to identify operative risks that may influence the recovery period. The evaluation includes an anesthetic plan that take into consideration the patient’s medical condition, the requirements of the surgical procedure and the patient’s preferences. A thorough assessment ensures that the patient’s chronic diseases are under appropriate medical therapy prior an elective procedure and establishes a rapport and confidence with the patient to allergy fears and answer my questions. Finally, the preoperative preparation involves procedures that are implemented based on the nature of the expected operation and the findings of the diagnostic workup and preoperative evaluation.
Many Dermatologic surgical procedures are uncomplicated, and extensive patient evaluation is unnecessary. Some of these simple procedures includes limited cryosurgery, curettage, electrosurgery , punch and saucerisation biopsies, and simple excisions. However, the need for patient evaluation is greater with more complex procedures, such as dermabrasion, hair transplantation, flaps, and grafts. Certain underlying pathophysiologic problems demand attention and caution. Medications and dietary supplements are often numerous and need to be scrutized of their impact on anesthetic agents, hemostasis, and wound healing. With the appropriate preoperative evaluation and precautions, many dermatologic procedures may be safely performed. The goals of this article are to present guidelines for performing a complete preoperative evaluation and highlights specific issues and management problems and issues that arise in patients undergoing dermatologic surgery.