PREOPERATIVE INCISION SITE SIGINING IN CANADIAN ORTHOPEDIC SURGERY

Abstract

Wrong site surgery is a preventable problem. In 1994 the Canadian Orthopaedic Association (COA) began an educational program initiated to prevent such mistakes from occurring. The purpose of this study was to assess the proportion of orthopedic surgeons who mark their sites preoperatively. This study confirms a high proportion (74.9%) of surgeons in Canada follow the COA guidelines at least occasionally with over half (52.1%) consistently “signing their sites.”

Wrong site surgery is often a catastrophic, but preventable problem. Reports of wrong site surgery have been on the rise in the United States every year since 1995. In 1994 the Canadian Orthopaedic Association (COA) began an educational program initiated to prevent such mistakes from occurring. Their recommendations involved marking the incision site preoperatively. Since that time the claims of wrong site orthopedic surgery have diminished. The purpose of this study was to assess the proportion of orthopedic surgeons who mark their sites preoperatively.

Two hundred orthopedic surgeons across Canada were asked to complete a survey concerning preoperative incision site marking.

A response rate of 89.3% was achieved. Eighty seven (52.1%) stated they always marked their incision site, thirty eight (22.8%) stated they occasionally marked their incision site, while forty two (25.1%) claimed to never mark their incision site preoperatively. Surgeons in academic centers were more likely to sign their sites than their community counterparts (p=0.021) and surgeons in practice longer were less likely to comply with the COA recommendation (p=0.023).

The COA and American Academy of Orthopedic Surgeons (AAOS) have recommended marking incision sites preoperatively in an attempt to reduce wrong site surgery. This study confirms a high proportion (74.9%) of surgeons in Canada follow the COA guidelines at least occasionally with over half (52.1%) consistently “signing their sites.”