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Safety First: Addressing Sharps Injuries in Mohs Surgery

Featuring Aaron Farberg, MD |

Bare Dermatology
Baylor Scott & White Health System
Dallas, TX

| Published May 20, 2024

In this quick-hitting installment of Topical Conversations, Aaron Farberg, MD, gives a concise and effective tip for preventing sharps injuries among Mohs surgeons and staff.

Prevalence and underreporting 

A recent survey of Mohs surgeons with membership in the American College of Mohs Surgery found that 56.7% have reported at least one sharps injury in the past year, mostly self-inflicted, of which 14.7% resulted in bloodborne pathogen exposure. 

Compounding this issue is the tendency to underreport, with 44.1% of the injured surgeons stating that they did not report their injuries.1 Another study that surveyed Micrographic Surgery and Dermatologic Oncology fellows about sharps injuries concluded that the most common reason for not reporting was a perceived low risk of infection.2 However, the risk of viral transmission following a sharps injury, while generally low, varies based on factors such as transmission mode and patient source risk factors.3 

A succinct strategy for reducing injuries 

As a practicing Mohs surgeon, Dr Farberg recognizes the critical role of practice in preventing such incidents, advocating for a culture of perfect practice within his clinic. He emphasizes the importance of ensuring that every member of the surgical team is well-versed in their respective roles and responsibilities to minimize the likelihood of errors. 

Developing and disseminating a standardized sharps handling protocol can also help mitigate the risk of injury among dermatologic surgeons and their staff.

The prevalence of sharps injuries among Mohs surgeons, coupled with the tendency to underreport these injuries, underscores the need for proactive measures to enhance workplace safety. By implementing proper training and standardized protocols, clinics can mitigate the risk of sharps injuries and safeguard the well-being of both surgeons and their staff. 


  1. Talebi-Liasi F, Lewin JM. A cross-sectional analysis of sharps injuries among dermatologic surgeons: a survey of American College of Mohs Surgery members. Dermatol Surg. 2023;49(11):985-988. doi:10.1097/DSS.0000000000003907 
  2. Santillan MR, Salian P, Weiss J. Sharps injuries during micrographic surgery and dermatologic oncology fellowship training. Dermatol Online J. 2022;28(6):17. 
  3. Brewer JD, Elston DM, Vidimos AT, Rizza SA, Miller SJ. Managing sharps injuries and other occupational exposures to HIV, HBV, and HCV in the dermatology office. J Am Acad Dermatol. 2017;77(5):946-951.e6. doi:10.1016/j.jaad.2017.06.040

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