Routine Pathologic Evaluation of Plastic Surgery Specimens: Are We Wasting Time and Money?

Plastic and Reconstructive Surgery
Mark FisherNeil Tanna

Abstract

Recent health care changes have encouraged efforts to decrease costs. In plastic surgery, an area of potential cost savings includes appropriate use of pathologic examination. Specimens are frequently sent because of hospital policy, insurance request, or habit, even when clinically unnecessary. This is an area where evidence-based guidelines are lacking and significant cost-savings can be achieved. All specimen submitted for pathologic examination at two hospitals between January and December of 2015 were queried for tissue expanders, breast implants, fat, skin, abdominal pannus, implant capsule, hardware, rib, bone, cartilage, scar, and keloid. Specimens not related to plastic surgery procedures were excluded. Pathologic diagnosis and cost data were obtained. A total of 759 specimens were identified. Of these, 161 were sent with a specific request for gross examination only. There were no clinically significant findings in any of the specimens. There was one incidental finding of a seborrheic keratosis on breast skin. The total amount billed in 2015 was $430,095. The infrequency of clinically significant pathologic examination results does not support routine pathologic examination of all plastic surgery specimens. Instead, t...Continue Reading

References

May 1, 1988·Plastic and Reconstructive Surgery·E C Smoot
Nov 1, 1987·Journal of Clinical Pathology·S B Coghill
Jan 1, 1997·The Journal of Arthroplasty·M L CampbellD R Mauerhan
Aug 7, 1998·Journal of Pediatric Surgery·D A PartrickS Z Ruyle
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Feb 14, 2006·The British Journal of Surgery·L E MatthyssensG G Champault
May 5, 2010·Plastic and Reconstructive Surgery·Peter F Koltz, John A Girotto
Sep 3, 2013·The Canadian Journal of Plastic Surgery = Journal Canadien De Chirurgie Plastique·Achilleas ThomaSophocles Voineskos

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Citations

Jan 29, 2019·Archives of Plastic Surgery·Jae-Won KimKyu Jin Chung
Dec 11, 2020·Plastic and Reconstructive Surgery. Global Open·Mark FisherScot B Glasberg

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