When is the best time to follow-up after Mohs surgery?

As Mohs micrographic skin surgery is the standard of care for treating stages of nonmelanoma skin cancers, phone calls following surgery are considered an integral part of the patient follow-up procedure and allow surgeons to address a variety of concerns including patient satisfaction, bleeding and pain. Researchers from the University of Missouri School of Medicine and MU Health Care conducted a survey to examine when is the optimal time to make that call?

The study was a randomized controlled trial that enrolled 400 patients into four arms. The first arm did not receive a phone call following Mohs micrographic surgery, while the second arm received a phone call from a physician on the evening of the surgery. Additionally, patients in the third arm received a phone call one day after surgery and patients in the fourth arm received a phone call two days after surgery.

All four arms received a follow-up phone call from research staff seven-10 days after the surgery was conducted to examine patient satisfaction.

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Study results demonstrate 83% of patients who were contacted the evening of the surgery encountered active pain versus 67% on day two and 51% on day three.

“We found follow-up calls made the evening of surgery best identified patients with active pain," says Nicholas Golda, M.D., associate professor of dermatology at the University of Missouri School of Medicine and senior author of the study. "This presents an opportunity to better coach patients through pain management and adjust medications if the calls are made on the evening of surgery rather than at other points."

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Results of the study also showed no patient arm expressly demonstrated higher pain levels or bleeding complications than the other, despite recognizing what group was at a higher risk of active pain following surgery. Also, the four arms were compared in order to examine different patient experiences, however, results showed no statistically significant differences in post-operative patient experiences.

"While surgeons may elect to make follow-up calls, these do not seem to strongly contribute to overall patient satisfaction," says Dr. Golda. "It is somewhat surprising that the control group's experience, quality of care and willingness to recommend scores matched the groups that received follow-up calls. This finding is contrary to our previously held belief that these calls directly affect patient satisfaction."

References:

1. Study Identifies Optimal Timing for Phone Calls After Skin Surgery. (2020, August 17). Retrieved September 09, 2020, from https://medicine.missouri.edu/news/study-identifies-optimal-timing-phone-calls-after-skin-surgery