RESUMEN
BACKGROUND: Reported infection rates for Mohs micrographic surgery (MMS) range from less than 1% to 3.5%. OBJECTIVE: To determine whether lower infection rates are possible for MMS with a consistently applied infection-control regimen. METHODS: A series of 832 consecutive patients with 950 tumors undergoing MMS formed the cohort for a retrospective study of infections before and after a program of heightened infection-control practices at a single-surgeon academic Mohs practice. The sterility upgrade included jewelry restrictions, alcohol hand scrub before stages and reconstruction, sterile gloves and (during reconstruction) sterile gowns for staff, and sterile towels and dressings for patients during Mohs stages. RESULTS: Infection rate was 2.5% (9 infections/365 tumors) before the sterility upgrade and 0.9% (5 infections/585 tumors) after, a statistically significant difference (p=.04). CONCLUSION: MMS already has low rates of infection, but this study shows that rigorous infection-control practices can significantly affect infection rates. The authors have indicated no significant interest with commercial supporters.
Asunto(s)
Control de Infecciones/métodos , Control de Infecciones/estadística & datos numéricos , Cirugía de Mohs/estadística & datos numéricos , Neoplasias/cirugía , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/prevención & control , Profilaxis Antibiótica/estadística & datos numéricos , Estudios de Cohortes , Femenino , Costos de la Atención en Salud , Humanos , Incidencia , Control de Infecciones/economía , Masculino , Persona de Mediana Edad , Cirugía de Mohs/efectos adversos , Neoplasias/clasificación , Estudios Retrospectivos , Medición de Riesgo , Esterilización/métodos , Esterilización/estadística & datos numéricos , Infección de la Herida Quirúrgica/etiología , Estados Unidos/epidemiologíaRESUMEN
Historical reviews suggest that tanning first became fashionable in the 1920s or 1930s. To quantitatively and qualitatively examine changes in tanning attitudes portrayed in the popular women's press during the early 20th century, we reviewed summer issues of Vogue and Harper's Bazaar for the years 1920, 1927, 1928, and 1929. We examined these issues for articles and advertisements promoting skin tanning or skin bleaching and protection. We found that articles and advertisements promoting the fashionable aspects of tanned skin were more numerous in 1928 and 1929 than in 1927 and 1920, whereas those promoting pale skin (by bleaching or protection) were less numerous. These findings demonstrate a clear shift in attitudes toward tanned skin during this period.