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Patient Concerns in the Immediate Postoperative Period After Mohs Micrographic Surgery
Cerrene N Giordano1, Shoko Mori1,2, Cristian Navarrete-Dechent1,3
1Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Background:
Postoperative concerns after Mohs micrographic surgery (MMS) are not well characterized.
Objective:
To better define patient concerns and contributing characteristics in the immediate postoperative period after MMS.
Materials And Methods:
A standardized telephone encounter template was implemented to better assess patient concerns in the 24-hour postoperative period. A review was then performed of patients undergoing MMS from October 2016 to July 2017 to assess for the most common patient concerns and association with clinical characteristics.
Results:
We included 307 patients. Overall, 60.6% of patients reported a concern. Fifty-four percent of patients reported pain. Most pain was characterized as "a little" (67.7%). On univariate analysis, flap repairs, location on the upper extremities, and swelling were associated with higher mean postoperative pain. Tumor type was not associated with increased pain. On multivariate analyses, patients with larger defects and associated edema were statistically significantly associated with higher degrees of pain.
Conclusion:
Over half of patients experience postoperative concerns after MMS, most commonly pain. The immediate postoperative period may be an optimal time to identify patient concerns allowing for reassurance or early intervention when necessary.
Insights
Over half of patients report concerns after Mohs micrographic surgery (MMS), most commonly pain. Identifying these issues early can help manage patient recovery.
Area of Science:
- Dermatology
- Surgical Oncology
- Patient Outcomes
Background:
- Postoperative concerns following Mohs micrographic surgery (MMS) are not well-defined.
- Understanding patient experiences is crucial for improving surgical care.
Purpose of the Study:
- To characterize patient concerns in the immediate 24-hour postoperative period after MMS.
- To identify clinical factors associated with these concerns.
Main Methods:
- A standardized telephone encounter template was used to assess patient concerns.
- A retrospective review of 307 patients undergoing MMS from October 2016 to July 2017 was conducted.
Main Results:
- 60.6% of patients reported postoperative concerns, with pain being the most common (54%).
- Higher pain levels were associated with flap repairs, upper extremity location, swelling, larger defects, and edema.
- Tumor type did not correlate with increased pain.
Conclusions:
- More than half of patients experience concerns, primarily pain, after MMS.
- The early postoperative period is a key time for identifying and addressing patient concerns.
- Early intervention and patient reassurance can improve outcomes after MMS.
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