A multicentre qualitative study of patient perceptions and experiences with secondary intention wound healing and skin grafting (PERCEIVE) across the United Kingdom and the Republic of Ireland.

IF 2.8 4区 医学 Q1 DERMATOLOGY
Puo Nen Lim, Jenny Caesar, Garret O'Connell, William Thomas Nicholas Hunt, Mohanad Aldiwani, Dushyanth Gnanappiragasam, Mun-Wai Lam, Gregory Parkins, Martin Porter, Rachel Abbott, Michael O'Connell, Thomas Oliphant, Simon Tso, Aaron Wernham
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Abstract

Background: For skin surgical sites that cannot be closed directly, alternative methods such as secondary intention healing (SIH) and full thickness skin grafting (FTSG) are utilised. Published literature on wound closure methods are primarily focused on objective outcomes such as healing time, cosmesis and postoperative complications. There is a paucity of literature exploring patient experiences with these wound reconstructive modalities.

Objectives: To explore patient experiences of skin surgery with SIH and FTSG.

Methods: This is a multi-centre interview based qualitative study involving 6 sites across the UK and the Republic of Ireland. One-to-one semi-structured interviews were conducted with patients who had an open surgical wound (for SIH) or a FTSG following excision of keratinocyte cancers. Patients were interviewed twice: one within a week post-surgery and another three months later. Audio recordings of interviews were transcribed verbatim and analysed using the six-step thematic analysis method by Braun and Clarke.

Results: 24 patients (19 males and 5 females; 12 SIH and 12 FTSG) with histologically confirmed keratinocyte cancers took part in the first interview. Age ranged 44 to 88 years. There were 22 completed second round interviews. Four key themes emerged: perception of overall quality of care (non-clinical), pre-operative experience, intra-operative experience, and post-operative experience. The first time patients visualised their surgical wound when changing dressing was a critical moment in their journey.

Conclusion: Patient experiences with skin surgery are highly individualised. Addressing their information needs, including those related to ancillary, and involving them in shared decision-making can enhance patient satisfaction.

一项多中心的定性研究,对英国和爱尔兰共和国患者的感知和经历进行了二次意向伤口愈合和皮肤移植(感知)。
背景:对于不能直接闭合的皮肤手术部位,可采用二次意向愈合(SIH)和全层植皮(FTSG)等替代方法。已发表的关于伤口闭合方法的文献主要集中在愈合时间、美容和术后并发症等客观结果上。缺乏文献探讨这些伤口重建模式的患者经验。目的:探讨皮肤手术中SIH和FTSG的患者经验。方法:这是一项基于多中心访谈的定性研究,涉及英国和爱尔兰共和国的6个地点。对角化细胞癌切除后开放性手术伤口(用于SIH)或FTSG的患者进行一对一半结构化访谈。患者接受了两次采访:一次是在手术后一周内,另一次是在三个月后。对访谈录音进行逐字抄录,并采用Braun和Clarke的六步主题分析法进行分析。结果:24例患者(男19例,女5例);12例组织学证实为角化细胞癌的SIH和FTSG患者参加了第一次访谈。年龄从44岁到88岁不等。有22人完成了第二轮面试。出现了四个关键主题:对整体护理质量的感知(非临床)、术前经验、术中经验和术后经验。患者在更换敷料时第一次看到手术伤口是他们旅程中的关键时刻。结论:皮肤手术患者的经历是高度个性化的。解决他们的信息需求,包括与辅助相关的信息需求,并让他们参与共同决策,可以提高患者满意度。
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来源期刊
CiteScore
3.20
自引率
2.40%
发文量
389
审稿时长
3-8 weeks
期刊介绍: Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.
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