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

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 utilized. 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 multicentre interview-based qualitative study involving six sites across the UK and the Republic of Ireland. One-to-one semistructured 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: once within a week postsurgery and again 3 months later. Audio recordings of interviews were transcribed verbatim and analysed using the six-step thematic analysis method by Braun and Clarke.

RESULTS

Twenty-four patients (19 male and 5 female; 12 SIH and 12 FTSG) with histologically confirmed keratinocyte cancers took part in the first interview. Their age ranged from 44 to 88 years. There were 22 completed second-round interviews. Four key themes emerged: perception of overall quality of care (nonclinical), preoperative experience, intraoperative experience and postoperative experience. The first time patients visualized their surgical wound when changing dressings was a critical moment in their journey.

CONCLUSIONS

Patients' experiences with skin surgery are highly individualized. Addressing their information needs, including those related to ancillary services, and involving them in shared decision making can enhance patient satisfaction.