[Patient counseling in case of postoperative complication leading to emergency reintervention in plastic surgery. What is the current situation? How to improve? Retrospective study of counseling modalities and traceability in a series of 16 patients who needed emergency reintervention within a cohort of 402 patients]

Ann Chir Plast Esthet. 2015 Aug;60(4):291-8. doi: 10.1016/j.anplas.2015.03.001. Epub 2015 Apr 8.
[Article in French]

Abstract

Aim: Preoperative counseling is structured and well defined. Nevertheless, in the event of a complication leading to a new emergency surgical procedure, counseling is not well defined. We conducted a retrospective study of information delivered in this situation at our institution.

Patients and methods: We included all the patients who underwent emergency reintervention because of hematoma or operative site infection between November 2013 and October 2014. Sixteen patients were included over the 402 patients operated during this period.

Results: Information before initial surgery: all patients had at least two preoperative consultations, and all preoperative informed consents were obtained. Complications leading to reintervention were mentioned in the consultation record in 31% of cases, and in a letter to another practitioner in 19% of cases. SofCPRE information card was delivered in 63% of cases. Information before reintervention: reintervention indication was mentioned in the hospitalization report in 81% of cases, and in the operative report in 88% of cases. Blood count results were mentioned in 55% of cases when it had been done. Patients were orally informed of reintervention in 100% of cases, and this new information was mentioned in 50% of cases. A new informed consent was signed in 31% of cases and postoperative letter was written in 25% of cases.

Conclusion: Information delivery traceability is mandatory. In case of complication leading to emergency reintervention, traceability should be done in the same way as prior to initial surgery.

Keywords: Complication; Consentement éclairé; Information; Informed consent; Professional responsibility; Reintervention; Reprise chirurgicale; Responsabilité professionnelle.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Counseling*
  • Female
  • Humans
  • Informed Consent
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects*
  • Postoperative Complications
  • Reoperation*
  • Retrospective Studies
  • Young Adult