Figure 1

Clinical example of correct versus incorrect modalities of surgical site marking. A: This patient was scheduled for a surgical procedure on his right forearm. The intern marked and initialed the site on the dressing, which came off prior to surgery (1). The resident corrected the mistake by marking the surgical site on skin, using a regular pen (2). Neither the marking, nor the initials, are well legible (2). Finally, the site was again marked and initialed by the attending surgeon with a permanent marker (3). B: During the surgical preparation, the site marking with the regular pen was washed off immediately (2), whereas the permanent marker remained visible throughout the surgical preparation (3). This example emphasizes the crucial importance of using a permanent marker, large and well legible letters, and to sign the marking with the surgeon's initials. "YES" is the designated, standardized identifier for the correct surgical site at Denver Health Medical Center.