ABSTRACT
SURGICAL ENVIRONMENT DEFINITION, CERTIFICATION, AND ACCREDITATION Performing invasive surgical procedures requires properly designed, well-organized surgical environments. A surgical environment can be dened as a space, within a medicalsurgical facility, where all sequential steps and operative details, necessary to perform properly selected surgical procedures, can nd an ergonomically organized place. Not all dermatologists perform the full range of invasive procedures offered by modern dermatologic surgery [5]. Surgical environment should therefore be planned according to different professional scenarios, respecting specic aims and requirements. Particular consideration should be given to the level of anesthesia usually required to perform invasive surgical procedures. Most dermatologic surgical procedures are performed under topical or local/regional/tumescent anesthesia, which should be considered as integral components of surgery. They do not usually require special authorization. More advanced invasive procedures might require IV sedation associated with local anesthesia or even general IV anesthesia. They should be included within the list of procedures performed by dermatologists in their ofce facilities, and specic authorizations should be obtained. Special professional assistance from boardcertied anesthesiologists should be absolutely available [6,7].
