Oral Presentation New Zealand Association of Plastic Surgeons Annual Scientific Meeting

A see-and-treat clinic to reduce skin cancer treatment time (439)

Scott McLaughlin 1 , John Kenealy 2 , Michelle Locke 1 2
  1. Faculty of Medical and Health Sciences, The University of Auckland, Auckland
  2. Department of Plastic, Reconstructive and Hand Surgery, Counties Manukau District Health Board, Auckland

Introduction

Plastic surgery departments have experienced increasing referrals for management of skin lesions that has led to prolonged patient waiting time for surgery. See-and-treat clinics may provide a solution to address this as they enable assessment and surgical treatment to occur in a single visit. A purpose built See-and-treat skin cancer clinic has been opened in Middlemore Hospital. The aim of this study was to determine if this clinic could provide patients with a faster treatment pathway with comparable outcomes to current practice and acceptability to patients.

Method

This study was a prospective observational audit of see-and-treat clinic patients with a retrospective control cohort. The prospective ‘See-and-treat’ cohort included a consecutive series of 106 patients, the first six weeks of patients treated with see-and-treat surgery. The retrospective cohort included a consecutive series of 200 patients treated immediately prior to the opening of the See-and-treat clinic. We collected information on patient waiting time from referral to surgery, completeness of excision and other operative measures. 100 patients in the prospective cohort also completed an anonymous post-operative questionnaire about their satisfaction with see-and-treat surgery.

 Results

The average waiting time for surgery was reduced from 121 days in the retrospective cohort to 35 days in the See-and-treat cohort (p<0.001). Rates of complete excision of malignant and premalignant lesions were 93% in the retrospective cohort and 91% in the See-and-treat cohort (p=0.609). The anonymous questionnaire revealed that 76% felt see-and-treat surgery reduced their anxiety, 90% felt it gave them enough time to make an informed decision about their treatment, and 94% were satisfied with their experience overall.

Conclusion

A considerable reduction in waiting time for skin cancer surgery was demonstrated in patients treated by the See-and-treat clinic, and success of treatment did not differ between cohorts. Questionnaire results revealed see-and-treat surgery is acceptable to patients.