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Research Letter
November 21, 2018

Assessment of Duration of Facial Plastic Ambulatory Surgery and Risk of ComplicationsA Systematic Review

Author Affiliations
  • 1Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology−Head and Neck Surgery, Oregon Health and Science University, Portland
  • 2Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology−Head and Neck Surgery, University Hospital of Brooklyn/SUNY Downstate and Kings County Hospital Center, Brooklyn, New York
  • 3Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook University, Stony Brook, New York
  • 4Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology−Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor
  • 5Allcroft Facial Plastic Surgery, Northampton, Massachusetts
  • 6Facial Plastic and Reconstructive Surgery, Division of Otolaryngology−Head and Neck Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania
  • 7Facial Plastic and Reconstructive Surgery Division, Department of Otolaryngology−Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland
  • 8Associate Editor, JAMA Facial Plastic Surgery
JAMA Facial Plast Surg. Published online November 21, 2018. doi:10.1001/jamafacial.2018.1636

Surgery volume in ambulatory surgery centers (ASCs) has increased markedly in recent decades, especially for plastic and reconstructive surgical procedures. Cosmetic procedure complication rates range from 0.33% to 1.9% at ASCs.1 State regulatory bodies have sought to limit procedure length at ASCs, citing the rationale that longer procedure duration may be associated with increased complication rates. In the United States, there are state-specific regulatory policies for ASCs. Pennsylvania limits surgery length to 4 hours, and Connecticut limits surgery length to 1.5 hours with a 4-hour recovery time. In 2009, an evidence-based safety advisory on patient selection and ambulatory surgery from the American Society of Plastic Surgery recommended a 6-hour maximum surgery length at ASCs.2

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