The Choosing Wisely campaign is an initiative of the ABIM Foundation. This campaign works to encourage patient and doctor conversations to ensure optimal care. The American Society of Plastic Surgeons proudly participates in this campaign. Choosing Wisely helps patients choose care that is supported by evidence, not duplicative of other tests received, free from harm and truly necessary. Patients should ask their doctors specific questions in order to receive all the information. The American Society of Plastic Surgeons has a commitment to providing quality care and helping patients make the most informed decisions about the procedure. To better serve patients and to ensure that surgical goals are met, the American Society of Plastic Surgeons works to improve evidence based clinical guidelines, quality measures and quality improvement programs. The American Society of Plastic Surgeon’s Health Policy, Patient Safety, and Quality and Performance Measurement Committees has compiled a list of five questions that every patient and doctor should ask before getting a procedure.
Avoid performing routine mammogram before breast surgery
For patients undergoing breast surgery, mammograms need to be ordered. This is based on existing clinical practice guidelines. This applies to all breast surgery patients including mastoplexy and breast reduction. The guidelines recommend annual mammogram screenings for patients in a particular age group. Patients undergoing elective breast surgery are not required by the guidelines to undergo additional screening. If a patient’s history or findings on a physical exam are worrisome, they may need to have further tests.
Avoid using drains in breast reduction mammaplasty
Drains may be able to minimize the amount of fluid at the surgical site. There is no evidence that supports the use of these drains. There is indication that the use of the drains neither increases nor decreases postoperative complications, greater patient discomfort, or increase in length of hospital stay. For patients that get liposuction for breast reduction, it is left up to the surgeon’s decision to use drains or not.
Avoid performing follow-up and routine mammograms of reconstructed breasts after mastectomies
Evidence has proved that clinical examination is effective enough to detect local cancer recurrence in patients. Clinical guidelines suggests routine clinical exams but imaging studies are not part of this recommendation. If there is any concerns during a clinical exam, imaging is recommended.
Avoid performing plain X-Rays in instances of facial trauma
The maxillofacial Computed Tomography is very sensitive for detecting fractures in instances of facial trauma. This is now available in most trauma centers. Evidence indicates that the x-ray may not be the best option in diagnostic care. It leads to substantial increase in costs and produces unnecessary doses of radiation. The plain x-ray is helpful only in mandibular trauma and dental.
Avoid continuing prophylactic antibiotics for greater than 24 hours after a surgical procedure
Evidence indicates that antibiotic prophylaxis is only necessary within the first 24 hours after surgery. The antibiotics are sufficient in preventing an infection at the surgical without taking them over 24 hours. Prolonged use of antibiotics may increase a resistance.
When deciding to get plastic surgery in Des Moines, ask Dr. Franks these questions. He is a board certified plastic surgeon and can effectively answer all your questions with assurance. For more information, contact 515.421.4299.