Follow-up by telephone questionnaire in outpatient oral and maxillofacial surgery

The SARS-CoV2 pandemic introduced a new problem in postoperative outpatient care: If I set a follow-up appointment at the clinic, will I endanger my patient? This study presents a different way to identify problems in the postoperative setting after outpatient procedures in our field- the telephone interview.

A study nurse conducted the telephone interview using a structured questionnaire within one week of minor outpatient oral and maxillofacial surgery. She asked about pain, swelling, numbness, and mouth opening limitations. Certain red flag answers (numbness, increasing pain, increasing swelling, pain keeping patient from sleeping, pain on swallowing) caused her to book an appointment for the patient in our clinic within the following 24 hours.

52 Patients completed the telephone questionnaire. Of those 3 (5.7%) had red flag answers that resulted in an appointment at the hospital within 24 hours. 2 (3.8%) of them were due to numbness. 24 (46.2%) patients reported no pain. On the numerical rating scale from 0 (no pain) to 10 (worst pain), the average reported pain was 2.24 (SE 0.30). Swelling was reported by 39 (75%) patients. 22 (42.3%) reported the swelling to be mild, 10 (19.2%) moderate, and 7 (13.5%) to be severe. 13 (25%) patients reported a limitation to mouth opening. None reported the interincisal distance to be smaller than one finger.

A structured telephone questionnaire can be a useful tool to discern postoperative complications and initiate necessary treatment. At the same time, it minimizes overtreatment. It can be used as a standard tool in the ambulatory treatment. It can be delegated to a secretary or ambulatory nurse with a standardized questionnaire to optimize resource use for selected patients. Moreover, patients describe it as a service to be called at home and they avoid unnecessary travel.