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Wound Care Adherence in Mohs Micrographic Surgery: A Prospective Cohort Study
Ryan Chen1, Steven Krueger1, Julie Flahive2
1Department of Dermatology, University of Massachusetts Chan Medical School, Worcester, Massachusetts.
Background:
Patients undergoing Mohs micrographic surgery (MMS) are given detailed wound care instructions to prevent postoperative complications. Previous studies have revealed low treatment adherence in general dermatology, but adherence to postoperative wound care and its potential association with poor surgical outcomes remain largely unstudied.
Objective:
To determine the frequency and causes of wound care nonadherence in patients who underwent MMS.
Materials And Methods:
A questionnaire containing a modified Eight-Item Morisky Medication Adherence Measure Scale was administered to Mohs patients at their 1 to 2 weeks postoperative visit.
Results:
Sixty-three patients were solicited and consented to completing the questionnaire. The average modified Eight-Item Morisky Medication Adherence Measure Scale score was 7.4 of 8, indicating high adherence. Old age and wound care assistance were associated with increased adherence. Factors contributing to nonadherence included feeling well, being too busy, wound care causing discomfort, and being with friends or family. One patient (1.6%) with high adherence developed an epidermal inclusion cyst within the scar. No other complications were observed.
Conclusion:
Most MMS patients demonstrated high adherence to wound care instructions, and nonadherence was not associated with postoperative complications.
Insights
Most patients undergoing Mohs micrographic surgery (MMS) show high adherence to wound care. Nonadherence was not linked to complications, suggesting current protocols are effective for MMS wound healing.
Area of Science:
- Dermatology
- Surgical Outcomes
- Patient Adherence
Background:
- Postoperative complications after Mohs micrographic surgery (MMS) are often mitigated by detailed wound care instructions.
- However, adherence to these instructions and its impact on surgical outcomes are not well-studied, unlike general dermatology adherence.
- Previous research indicates low adherence rates in general dermatology settings.
Purpose of the Study:
- To assess the frequency and identify the reasons for wound care nonadherence in patients who underwent MMS.
- To investigate the relationship between adherence to MMS wound care and postoperative complications.
Main Methods:
- A modified Eight-Item Morisky Medication Adherence Measure Scale questionnaire was used.
- The questionnaire was administered to patients 1-2 weeks post-MMS surgery.
- Sixty-three patients completed the survey.
Main Results:
- The average adherence score was 7.4 out of 8, indicating high patient adherence to MMS wound care.
- Older age and assistance with wound care correlated with higher adherence.
- Reasons for nonadherence included feeling well, being busy, discomfort, and social factors.
- Only one patient (1.6%) experienced a minor complication (epidermal inclusion cyst).
Conclusions:
- The majority of patients undergoing MMS exhibit high adherence to postoperative wound care instructions.
- Nonadherence to MMS wound care did not correlate with adverse surgical outcomes in this study.
- Current wound care protocols appear effective in preventing complications post-MMS.
