TO THE EDITOR:
I am writing this letter in response to "Editorial. Wrong-Site Surgery" (80-A: 463, April 1998), by Cowell. As Cowell mentioned, the American Academy of Orthopaedic Surgeons has initiated a campaign against wrong-site surgery. Certainly, operating on the wrong side or wrong part is a potential problem that is bad for patient care and can lead to a lawsuit. A number of methods for preventing this problem have been developed, and identification of the proper site with some sort of a marker has been recommended. However, a number of objections have been made against such marking of the operative site, apparently because of the potential for infection. I suggest a much more simple, common-sense approach, which I have used for many years. My technique is to write "NO" on the side not to be operated on in large letters with a black marker. This lettering cannot possibly interfere with the operative site, and, because it is on the contralateral limb, it does not lead to any risk of infection. This technique serves the same purpose as writing on the side to be treated, without the need to actually put anything near the planned operative site.
I just offer this as another method of preventing wrong-site surgery.
John P. Lubicky, M.D.: Shriners Hospital for Children Chicago, 2211 North Oak Park Avenue, Chicago, Illinois 60707-3392
Dr. Cowell replies:
Dr. Lubicky correctly points out that there are a number of ways to avoid wrong-site surgery. As I noted in my Editorial, I, too, used a different method than that endorsed by the Academy.
The purpose of the Editorial was to alert the readers of The Journal to the problem and to provide the Academy's recommendations for avoiding wrong-site surgery. Each physician must choose what he or she believes, in his or her hands and in his or her judgment, to be the best means of avoiding wrong-site surgery. I thank Dr. Lubicky for bringing this simple alternative method to the attention of our readers.
Henry R. Cowell, M.D., Ph.D.: Editor, The Journal of Bone and Joint Surgery