Scar Revision Surgery: The Patient's Perspective.
10.5999/aps.2015.42.6.729
- Author:
Benjamin H MIRANDA
1
;
Anna Y ALLAN
;
Daniel P BUTLER
;
Paul D CUSSONS
Author Information
1. Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK. DrBMiranda@googlemail.com
- Publication Type:Original Article
- Keywords:
Patient satisfaction;
Scarring;
Standards;
Plastic surgery;
Patient selection
- MeSH:
Cicatrix*;
Demography;
Female;
General Practitioners;
Humans;
Male;
Patient Satisfaction;
Patient Selection;
Prospective Studies;
Referral and Consultation;
Surgery, Plastic;
Telephone;
Wounds and Injuries
- From:Archives of Plastic Surgery
2015;42(6):729-734
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Insufficient satisfaction outcome literature exists to assist consultations for scar revision surgery; such outcomes should reflect the patient's perspective. The aim of this study was to prospectively investigate scar revision patient satisfaction outcomes, according to specified patient-selection criteria. METHODS: Patients (250) were randomly selected for telephone contacting regarding scar revisions undertaken between 2007-2011. Visual analogue scores were obtained for scars pre- and post-revision surgery. Surgery selection criteria were; 'presence' of sufficient time for scar maturation prior to revision, technical issues during or wound complications from the initial procedure that contributed to poor scarring, and 'absence' of site-specific or patient factors that negatively influence outcomes. Patient demographics, scar pathogenesis (elective vs. trauma), underlying issue (functional/symptomatic vs. cosmetic) and revision surgery details were also collected with the added use of a real-time, hospital database. RESULTS: Telephone contacting was achieved for 211 patients (214 scar revisions). Satisfaction outcomes were '2% worse, 16% no change, and 82% better'; a distribution maintained between body sites and despite whether surgery was functional/symptomatic vs. cosmetic. Better outcomes were reported by patients who sustained traumatic scars vs. those who sustained scars by elective procedures (91.80% vs. 77.78%, P=0.016) and by females vs. males (85.52% vs. 75.36%, P<0.05), particularly in the elective group where males (36.17%) were more likely to report no change or worse outcomes versus females (16.04%) (P<0.01). CONCLUSIONS: Successful scar revision outcomes may be achieved using careful patient selection. This study provides useful information for referring general practitioners, and patient-surgeon consultations, when planning scar revision.
