Case Western Reserve University School of Medicine, Cleveland, Ohio.
Case Western Reserve University School of Medicine, Cleveland, Ohio; Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
J Am Acad Dermatol. 2019 Dec;81(6):1339-1345. doi: 10.1016/j.jaad.2019.05.085. Epub 2019 Jun 1.
Perioperative patient anxiety in Mohs micrographic surgery (MMS) is associated with increased postoperative pain and decreased satisfaction.
To determine whether a 3-dimensionally printed MMS model with standardized education (SE) improves perioperative patient understanding and anxiety.
An unblinded, randomized controlled trial was conducted, with patients randomly assigned to receive the MMS model plus SE or SE alone. Baseline and poststage understanding and anxiety were evaluated with the Visual Analog Scale (VAS) and State-Trait Anxiety Inventory (STAI). Additionally, patients completed a 6-item knowledge assessment.
Eighty-two patients were enrolled, 42 in the MMS model and 40 in the SE group, with similar group mean age (67.8 years), sex (59.8% male), and previous MMS experience (47.6%). Both groups experienced significant reductions in VAS anxiety and State-Trait Anxiety Inventory scores and significant increases in VAS understanding. Compared with SE alone, the MMS model group had larger VAS anxiety reduction (change, -1.31; approaching significance) than the SE group (change, -0.52; P = .052) and 5.59 (93.25%) correct responses versus 5.15 (85.83%) correct responses in the SE group (P < .028).
Overestimations of baseline patient anxiety in our population and 91.1% recruitment of the intended study population limited study power.
A 3-dimensionally printed MMS model with SE may improve patient understanding of MMS and decrease perioperative anxiety.
Mohs 显微描记手术（MMS）围手术期患者焦虑与术后疼痛增加和满意度降低有关。
确定具有标准化教育（SE）的 3 维打印 MMS 模型是否能提高围手术期患者的理解和焦虑程度。
进行了一项非盲、随机对照试验，患者被随机分配接受 MMS 模型加 SE 或 SE 单独治疗。使用视觉模拟量表（VAS）和状态-特质焦虑量表（STAI）评估基线和各阶段的理解和焦虑程度。此外，患者完成了 6 项知识评估。
共纳入 82 例患者，MMS 模型组 42 例，SE 组 40 例，两组平均年龄（67.8 岁）、性别（59.8%为男性）和之前接受 MMS 治疗的经验（47.6%）相似。两组的 VAS 焦虑评分和状态特质焦虑量表评分均显著降低，VAS 理解评分均显著升高。与 SE 单独治疗相比，MMS 模型组的 VAS 焦虑减轻程度更大（变化，-1.31；接近显著），而 SE 组的 VAS 焦虑减轻程度较小（变化，-0.52；P = 0.052），MMS 模型组有 5.59 个（93.25%）正确回答，而 SE 组有 5.15 个（85.83%）正确回答（P < 0.028）。
我们研究人群中高估了基线患者焦虑程度，以及仅招募了预期研究人群的 91.1%，限制了研究效力。
具有 SE 的 3 维打印 MMS 模型可能提高患者对 MMS 的理解，并降低围手术期焦虑。
