Background: Recent healthcare changes have encouraged efforts to decrease costs. In plastic surgery, an area of potential cost savings includes appropriate utilization of Pathology. Specimens are frequently sent because of hospital policy, insurance request, or habit, even when clinically unnecessary. This is an area where evidence-based guidelines are lacking and significant cost-savings can be achieved. Methods: All specimen submissions to pathology at two hospitals between January and December 2015 were queried for tissue expanders, breast implants, fat, skin, abdominal pannus, implant capsule, hardware, rib, bone, cartilage, scar, and keloid. Specimens not related to plastic surgery procedures were excluded. Pathological diagnosis and cost data were obtained. Results: A total of 759 specimens were identified. Of these, 161 were sent with a specific request for gross examination only. There were no clinically significant findings in any of the specimens. There was one incidental finding of a seborrheic keratosis on breast skin. Total amount billed in 2015 was $430,095. Conclusion: The infrequency of clinically significant pathology results does not support routine pathologic examination of all Plastic Surgery specimens. Instead, the authors justify select submission only when there is clinical suspicion or medical history that warrants evaluation. By eliminating unnecessary histological or macroscopic examination, significant cost savings may be obtained. Presented as an oral presentation at 96th Annual Meeting and Symposium of American Association of Plastic Surgeons (AAPS), Austin, TX, March 28, 2017. Financial Disclosures: None of the authors have a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author: Neil Tanna, M.D., M.B.A., ntanna@gmail.com, 516-497-7900, 516-497-7920 (fax), 130 E 77th St, 10th Floor, New York, NY 11042 ©2017American Society of Plastic Surgeons
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