Wednesday, April 3, 2013


In view of recent allegations concerning violations of sterilization standards in a Tulsa oral surgeon's office, I thought I would address this issue.  The number one priority in surgical procedures is patient safety.  Sterile technique is also a top priority with any surgical intervention, whether it be in the office or hospital/surgical center operating room.

Any needle or knife blade used to violate the skin is a pre-packaged, sterile, one-time use instrument.

In the surgical center and hospital setting, sterilization procedures of instruments and equipment used on the surgical field are carefully monitored to insure complete sterility.  I rely on the hospital and surgery center to follow strict protocols in their sterilization procedures.  Although I do not personally get involved in the sterilization process, I have complete trust in the facilities in which I operate in and I would not hesitate to have surgery personally or have one of my family members undergo surgery in these facilities. The two facilities used for my major surgical procedures are St. John Medical Center and Union Pines Outpatient Surgical Center.  Both facilities are accredited by the Joint Commission on the Accreditation of Health Care Facilities which periodically inspects and issues accreditation to these facilities based on multiple standards including sterilization protocols.

For office surgical procedures, we also follow strict sterilization procedures. Similar to the hospital/surgical center, any needle or knife blade used to violate the skin is a pre-packaged, sterile, one-time use instrument. All instruments used for surgery are personally cleaned and inspected by me prior to sterilizing in a
Ritter M9 Ultraclave Steam Sterilization Unit.
For each sterilization cycle, chemical indicators are used to assure minimum sterilizing conditions have been achieved. In addition, periodic biological monitoring is performed using CDC (Centers for Disease Control) and OSHA guidelines.  All functions of the sterilizer are monitored and inspected periodically by a certified technician.

As a board certified surgeon, I make sterility a top priority in any surgical procedure. My goal is to achieve a safe and successful surgical outcome. Despite our best efforts, infections do occur. Occasionally I am asked, "why did I get an infection"?  I wish we knew the answer to that question.  There are multiple reasons that some patients are more pre-disposed to infection. For some patients, their immune system is not strong enough to fight bacterial or viral organisms.  We know that bacteria and viruses are within our body and on the skin. Usually our immune system is good enough to keep these organisms in check to prevent clinical infection. Smoking and nicotine products can compromise blood supply and lead to a higher risk of infection. Previous radiation therapy can compromise blood supply and cause healing issues and infection in a surgical procedure. Diabetes and other disease states put the patient at higher risk for infection. Poor home conditions and hygiene may play a role in certain patients. Certain medications such as steroids can pre-dispose to infection.

If infections occur, many of the current organisms are more aggressive, can cause more tissue damage and scarring, and are more difficult to treat. Culture and sensitivity studies guide us as to the appropriate drug to treat the infection.  Fortunately, infections are rare and usually can be eradicated.

Please feel free to discuss infection issues and ask questions prior to any surgical procedure. Infections complicate your life, but also complicate my life and increases stress levels for both of us. I will do everything within my power to prevent infection!!