• John Starling and Brett M Coldiron.
• Skin Cancer Center, Cincinnati, Ohio 45213, USA. johnthree@gmail.com
• J. Am. Acad. Dermatol. 2011 Oct 1;65(4):807-10.

BackgroundPatient safety is emerging as an integral part of the overall strategy to improve health care in the United States. Wrong site surgery is correctly noted to be a sentinel event and great efforts must be made to avoid it.ObjectiveWe sought to determine the incidence of wrong site surgery after implementation of a preoperative protocol in patients presenting for treatment of skin cancer at a high-volume, Joint Commission-accredited, tertiary referral center for dermatologic surgery.MethodsA retrospective chart review was performed of 7983 cases performed on patients presenting for treatment of skin cancer in the office setting.ResultsThere were no cases of wrong site surgery. There were, however, 18 cases of failure to identify the original biopsy site (cancer site).LimitationsThis was a retrospective study done at one cancer center.ConclusionIntegration of a correct surgery site protocol into a daily patient care model is a useful step in preventing occurrences of wrong site dermatologic surgery.Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

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