Chitgopeker Pooja, Sidey Kirk, Aronson Adam, Hammel Josh, Noe Megan H, Auh Sogyong, Lehrer Michael, Hopp Shelby, Johnson-Jahangir Hillary, VanBeek Marta, Ferguson Nkanyezi
Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Iowa Methodist Medical Center, Department of Internal Medicine, Des Moines, Iowa.
Dermatol Surg. 2019 Feb;45(2):234-243. doi: 10.1097/DSS.0000000000001750.
Despite extensive counseling, patients commonly call with postoperative concerns after Mohs micrographic surgery (MMS).
We sought to determine the incidence, reasons, and patient and surgical characteristics that lead to patient-initiated communication after MMS.
A retrospective chart review of 1,531 patients who underwent MMS during the observational period was conducted. Demographics and perioperative characteristics of patients who initiated communication were compared with a random sample of matched controls.
Of the 1,531 patients who underwent MMS, 263 patients (17.2%) initiated 412 communication encounters within 90 days of surgery. Top reasons for patient-initiated communication included wound concerns, bleeding, and postoperative pain. Female patients and those with a larger surgical defect size (cm) were more likely to call postoperatively. Patients who underwent second intention healing, grafts, and interpolation flaps were more likely to initiate communication compared to patients repaired with a linear closure.
This study identifies the incidence, reasons, and patient and surgical factors predictive of patient-initiated communication after MMS, which may allow for targeted improvements in postoperative counseling, ameliorating patient anxiety, augmenting patient satisfaction, and improved efficiency for the health care team.
尽管进行了广泛的咨询，但患者在莫氏显微外科手术（MMS）后仍常来电咨询术后相关问题。
我们试图确定MMS后患者主动沟通的发生率、原因以及患者和手术特征。
对观察期内接受MMS的1531例患者进行回顾性病历审查。将主动沟通的患者的人口统计学和围手术期特征与匹配对照的随机样本进行比较。
在接受MMS的1531例患者中，263例患者（17.2%）在术后90天内发起了412次沟通。患者主动沟通的主要原因包括伤口问题、出血和术后疼痛。女性患者以及手术缺损面积较大（厘米）的患者术后更有可能来电。与接受线性缝合修复的患者相比，接受二期愈合、植皮和插入皮瓣的患者更有可能主动沟通。
本研究确定了MMS后患者主动沟通的发生率、原因以及预测因素，这可能有助于针对性地改善术后咨询，减轻患者焦虑，提高患者满意度，并提高医疗团队的效率。
