Dermatological postoperative patient information leaflets: is it time for more uniformity?
BACKGROUND
Patient information leaflets (PILs) are an important source of information for patients postoperatively. There are currently no nationally agreed standards by dermatologists for postoperative advice following skin surgery.


OBJECTIVE
To assess the common themes and areas of variation in advice given in PILs after skin surgery across all National Health Service (NHS) hospitals in England and Wales.


METHODS
All acute trusts in England (n = 159) and local health boards in Wales (n = 7) were requested to provide their postoperative dermatological PILs for general sutured wound care or excision biopsy. Eight preselected parameters were assessed: minimum dressing duration, duration of pressing on a bleeding wound, postoperative analgesia, explanation of infection signs, application of petroleum jelly, scarring, whom to contact if there is a problem, and the recommended postoperative time for abstaining from active exercise.


RESULTS
PILs were received from 137 different dermatology departments belonging to 127/166 (76.5%) organisations across England and Wales. Of these, 102 PILs gave a specific duration for dressings: 45/102 (44.1%) advised a minimum of 48 h, but 28/102 (27.5%) recommended leaving dressings in place until suture removal. Regarding duration of pressing on a bleeding wound, 117 PILs gave advice, with the most common recommendation being 15 min (30/117, 25.6%), followed closely by 10 min (26/117, 22.2%). Of the 137 PILs received, 125 gave advice regarding postoperative analgesia, with paracetamol alone being the most common recommendation (24/125, 19.2%). For the remaining parameters, 111/137 (81.0%) PILs described ≥ 2 signs of infection, 42/137 (30.7%) recommended the application of petroleum jelly, 65/137 (47.4%) mentioned scarring, 137/137 (100%) highlighted whom to contact if there were postoperative problems and 87/137 (63.5%) PILs gave advice regarding postoperative abstinence from active exercise.


CONCLUSIONS
The advice given in dermatology postoperative PILs across England and Wales is highly variable. A nationally agreed template or set of postoperative advice should be considered to improve consistency.
Dermatology Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK.
W T N
WT
Hunt
Dermatology Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK.
E J
EJ
McGrath
D000698:Analgesia / Q000379:methods; D001458:Bandages; D004739:England; D057220:Health Literacy; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control / Q000628:therapy*; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D011182:Postoperative Care / Q000379:methods*; D012871:Skin Diseases / Q000601:surgery*; D013222:State Medicine; D014852:Wales