Laser Surgery Complications Commonly Result from User Error

User error is one of the leading causes of cosmetic laser surgery complications that result in scars, blistering, and infection, according to a new study.

Researchers at the University of Minnesota (UMN; Minneapolis, USA) reviewed US Food and Drug Administration (FDA) manufacturer and user adverse-event reports of documented complications in cosmetic laser- and energy-based surgeries to determine the most common errors and recommend steps needed to reduce patient complications. In all, 494 events were examined and identified per laser manufacturer, device used, event type, injury type, cause, operator, and indication for treatment for each case.

The results of review showed that of the 494 cases identified between 2006 and 2011, the most common complications were burns, scarring, blistering, pigmentation damage, and infection. The most common cause of these complications was user error by a healthcare provider (30%), followed by laser device malfunction (20%), and patient error (4%). Indications for treatment were unknown for 69% of cases, and 38% of the cases had an unknown cause of complication. The study was published in the April 2014 issue of Dermatologic Surgery.

“User error was a major factor in laser surgery complications,” concluded senior author Brian Zelickson, MD. “To improve safety and reduce errors, we propose the implementation of a procedural sequence for cosmetic laser surgery.”

The number of different cosmetic laser systems available has increased dramatically, as has the volume of laser procedures performed, and the number of resulting complications observed. These include hyperpigmentation, hypopigmentation, erythema, blistering, infection, and scarring. In fact, any undesired effect of a laser intervention is considered a complication; for example, erythema following carbon dioxide laser resurfacing, which occurs in almost 100% of patients treated, is still noted as a complication.

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