Medical considerations in ambulatory surgery

With the establishment of office-based surgical facilities have come alterations in the practice of plastic surgery. The plastic surgeon who chooses to perform operations in such a facility assumes total responsibility for patient care in the perioperative period. The opportunity to discuss problems in patient care, receive immediate consultative guidance, and share responsibility, so readily available in a hospital setting, is markedly limited. Inherent within his acceptance of this increased responsibility is the need to continuously educate himself and his staff in the current techniques of diagnosis and treatment of a wide variety of nonsurgical conditions. Now, in addition to improving his technical expertise as a plastic surgeon, he must become proficient in preoperative evaluation, management of common medical conditions, and recognition and treatment of iatrogenic pharmacologic complications.