P69: Complications and patient satisfaction in dermatology minor operations and Mohs micrographic surgical procedures

Qingwei Zhang,¹ Febisayo Sidiku,¹ Alisha Chamba,¹ Aland Maulod,² James Shelley,³ Louise Fearfield³ and Prativa Jayasekera³

¹Faculty of Medicine, Imperial College London, London, UK; ²Barts and The London School of Medicine and Dentistry, London, UK; ³Chelsea and Westminster Hospital, London, UK

Minor operation procedures (MOPs) and Mohs micrographic surgery (MMS) are common dermatology procedures with overall high cure rates for skin cancers. Patient satisfaction and complication occurrence are not often reported in measuring their success but have important implications on perceived quality of life, subsequent adherence to medical advice and likelihood of complaints. The aim of this study was to identify the complication rates and patient satisfaction of these procedures. This retrospective study involved contacting 309 patients who underwent MOP (n = 197) or MMS procedures (n = 112) via telephone. Patients completed a qualitative questionnaire, to determine the rate of occurrence of acute and delayed complications (haematoma, postoperative haemorrhage, wound dehiscence). Patient satisfaction was measured via a Likert scale (1 = waiting time; 2 = face-to-face contact; 3 = information; 4 = interaction with healthcare professionals; 5 = cosmetic outcome). The data were extracted, analysed and visualized using Microsoft Excel. Statistical analysis was done with Microsoft Excel Analysis Toolpak and SPSS. In total, 197 MOP patients were called, with a 53.8% response rate (n = 106). The cohort had a mean (SD) age of 61.1 (15.0) and 49.0% (n = 52) were male. Acute complications (≤ 24 h) included wound dehiscence [n = 1 (0.9%)], no patients experienced haematoma or haemorrhage. Delayed complications (> 24 h) included wound dehiscence [n = 2 (1.9%)] and postoperative haemorrhage [n = 3 (2.8%)], with no patients experiencing haematoma. On average, MOP patients rated their interaction with surgeon and nurse as 4.9 (0.49) and 4.9 (0.47), respectively, as 4.7 (0.86) for local anaesthetic experience, as 4.6 (0.87) for quality of postoperative advice received and as 4.5 (1.05) for cosmetic outcome. In total, 112 patients undergoing MMS were called, with a 73.2% response rate (n = 82). Median age was 77.5 (range 35.4–90.4) and 58.5% (n = 48) were male. Acute complications included postoperative haemorrhage [n = 3 (3.7%)]; no patient experienced haematoma or wound dehiscence. Delayed complications included wound dehiscence [n = 1 (1.2%)]; no patients experienced haematoma or postoperative haemorrhage. On average, patients undergoing MMS rated their interaction with surgeon and nurse as 5.0 (0.27) and 4.9 (0.36), respectively, as 4.7 (0.79) for experience with local anaesthetic, as 4.8 (0.60) for quality of postoperative advice received and 4.6 (0.61) for cosmetic outcome. We found a similar overall rate of acute and delayed complications following MMS vs. literature figures; however, MOPS figures are not well reported. There was a high rate of satisfaction overall, with 98.9% of patients reporting that they would recommend the service. The assessment of outcomes after both MMS and MOPS should include recurrence and complication rates, and cosmetic satisfaction, in order to link patient satisfaction to more objective parameters.