Department of Dermatology, Naval Medical Center Portsmouth, Portsmouth, Virginia.
Department of Dermatology, Naval Medical Center San Diego, San Diego, California.
Dermatol Surg. 2021 Apr 1;47(4):462-466. doi: 10.1097/DSS.0000000000002787.
Preoperative patient screening has been evaluated in many surgical specialties as a way to improve the overall patient experience. Current data are limited regarding patient screening for dermatologic procedures. The goal of preoperative screening is to identify patients at risk for poor outcomes and tailor the treatment plan to ensure a greater overall patient experience.
To investigate the association between psychological comorbidities and acute postoperative pain in patients treated with Mohs micrographic surgery (MMS).
Subjects were recruited from a single center, single provider, uniformed service MMS practice, and asked to complete preoperative and postoperative questionnaires for scheduled MMS. Outcome variables included anticipated pain, actual pain after MMS, duration of pain, and medications used for pain.
Mohs micrographic surgery was well tolerated. There were no significant differences in anticipated or reported pain, or in medication use between cohorts. Significant differences in pain were noted with closure technique with complex surgical repairs generating the greatest pain across groups.
Mohs micrographic surgery is well tolerated by patients, both with and without psychological comorbidities. Our results show no statistically significant differences, suggesting a limited role for preoperative screening as a tool to guide pain management after MMS.
术前患者筛查已在许多外科专业中进行了评估，作为改善整体患者体验的一种方法。目前关于皮肤科手术患者筛查的数据有限。术前筛查的目的是识别有不良预后风险的患者，并调整治疗计划，以确保患者获得更好的整体体验。
调查在接受 Mohs 显微外科手术 (MMS) 治疗的患者中，心理合并症与急性术后疼痛之间的关联。
研究对象从一个单一中心、单一提供者、统一服务的 MMS 实践中招募，并要求他们在计划接受 MMS 治疗前和治疗后完成问卷。结果变量包括预期疼痛、MMS 后的实际疼痛、疼痛持续时间和用于缓解疼痛的药物。
MMS 治疗耐受性良好。在预期或报告的疼痛或药物使用方面，各队列之间没有显著差异。不同的闭合技术会导致显著的疼痛差异，其中复杂手术修复的患者疼痛最大。
患有和不患有心理合并症的患者均能很好地耐受 MMS。我们的结果没有显示出统计学上的显著差异，这表明术前筛查作为指导 MMS 后疼痛管理的工具的作用有限。
