D. Zamil1, S. Kamepalli1, J. Fernandez1, I. Shimizu1, S. Alkul1 1Baylor College Of Medicine, Houston, TX, USA
Introduction: Perioperative counseling regarding activity limitations is critical for patients undergoing dermatologic surgery. Current post-operative instructions regarding activity limitations may be inadequate, but this cannot be determined without knowing patient expectations and concerns. The purpose of this study was to elucidate patient expectations for counseling on post-operative activity limitations and to determine if increased counseling would impact patient planning pre- or post-operatively.
Methods: Patients who had excisions on the neck, torso, or extremities at Baylor College of Medicine in the 2019 calendar year by the same surgeon were invited to participate in an IRB approved phone survey. Questions addressed pre-existing activity level, activity changes after surgery, amount of counseling received, and perioperative counseling expectations. Multivariable logistic regression was used to determine factors associated with patient perceptions about counseling, activity limitations, and surgical outcomes.
Results: Table I shows logistic regression results. Patients who were adequately counseled on post-operative activity limitations reported they were unlikely to have made further arrangements to their surgical/personal schedule had they been given additional counseling. The inverse was also true. When patients received the amount of counseling they expected, they were less likely to want to reschedule surgery or adjust personal plans. Younger patients and those with surgery on the lower extremities were more likely to limit their activity for longer periods of time.
Conclusion: As instructions on activity limitations become more transparent, patients can make informed decisions regarding their surgical and personal schedules. This study can guide dermatologic surgeons in adjusting postoperative instructions to improve patient understanding of activity limitations, compliance, and the overall quality of their surgical experience. Younger patients, who may have busier work schedules, or those with surgery on areas like the lower extremities, may be better prepared for surgery with standardized, evidence-based instructions. Additional research to create standardized activity limitations, depending on patient population and excision site, may help further guide surgeons as they counsel their patients. We have incorporated our results by creating personalized hand-outs that will guide patients post-operatively. It is our hope that such handouts will also serve as a framework to encourage other dermatologic surgeons to further enhance the delivery of their postoperative instructions, specifically as it relates to activity limitations, to improve patient understanding, compliance, and satisfaction.
