Background: Patients are sent instructions to remain on all anticoagulation before attending the ‘see and treat’ local anaesthetic skin cancer clinic at Burwood Hospital, Christchurch. The authors assessed whether this was appropriate advice or resulted in surgery deferments.
Method: 64 clinics over 3 months were audited to review the rates of surgery deferment due to anticoagulation which included 888 patients.
Results: 728 (81.98%) of patients had immediate operations and 3.15% (N=28) had surgery deferred for any reason. The average age of patients operated on was 70.16 and 54.73% were male. Of those patients deferred, 8 patients were due to anticoagulation (28.57% of all deferments, 0.90% of total patients seen). 62.50% of these patients (n=5) were on warfarin, 1 patient was taking Dabigatran and Clopidogrel and one patient taking Clopidogrel only. Other reasons for deferment included patient or surgical factors that made a general anaesthetic or main theatre more appropriate, patients going overseas close to surgery, needle phobia and not enough time in the clinic to complete surgery. Of note, 6.31% of patient Did Not Attend (DNA) clinic and 7.09% patients were seen and discharged without needing surgery.
Discussion: There is a long wait time (up to 5 months) to be seen in this clinic due to limited resources and high demand in Christchurch. The authors wanted to assess whether there were high rates of deferments due to departmental device which would put strain on our service.
Conclusion: The authors conclude that advice given resulted in the relatively low number of deferments due to anticoagulation (0.90% of total patients). Further improvement could be made in reducing the number of patients that do not attend clinic.