A Survey among Public Hospitals on Care of Patients undergoing Breast Core Needle Biopsy

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Authors (including presenting author) :
Wong L (1,8), Chan SY(2,8), Wong KY (3,8), Chan CS Angela (4,8), Chun OK (5,8), Tsang WF(6,8), Lee MH(7,8)
Affiliation :
Surgical Department, QMH & TWH (1); Surgical Department, QEH (2), Kowloon East Cluster Breast Centre, United Christian Hospital (3); Surgical Department, NDH(4); Surgical Department, KWH (5); Surgical Department, POH (6); Surgical Department, RTSKH (7); Surgical Nursing Advisory Group (Breasat Care)
Introduction :
Nowadays, core needle biopsy (core biopsy) becomes the standard procedure for diagnosis of breast lesion. It has a potential risk of bleeding that can be controlled by applying direct pressure. Bruise may appear, but resolve within days. Other uncommon complications include hematoma and infection. The method of applying direct pressure and types of dressing material used after biopsy are different among hospitals. Therefore, a survey was conducted to evaluate the outcomes of care between hospitals.
Objectives :
1. To evaluate complications and skin condition after biopsy among different hospitals 2. To assess patients’ compliance to start bathing as instructed
Methodology :
A survey was conducted in Kwong Wah Hospital (KWH), Pok Oi Hospital (POH), North District Hospital (NDH) and Tung Wah Hospital (TWH) from November to December 2018. All patients received breast core biopsy were recruited except those with bleeding tendency. Patients were instructed to apply direct pressure or pressure dressing till bleeding stopped. Afterwards, biopsy site was covered with Elastoplast dressing, Mefix dressing, transparent film dressing and foam dressing in KWH, POH, NDH and TWH respectively. On the day of procedure, patients were advised to avoid strenuous activity for 24 hours; and start bathing after removal of dressing (in KWH, POH and NDH)or same day of the procedure if foam dressing is applied (in TWH). Dressing was removed on Day 1 in KWH and POH, Day 2 in NDH and Day 3 in TWH. 7-10 days after the procedure, through nurses’ inspection or patients’ reporting, wound complications, skin condition and time to start bathing were recorded.
Result & Outcome :
Results: A total of 176 patients were recruited from KWH (n=26), POH (n=50), NDH (n=50) and TWH (n=50). No patient (0/176) was reported of bleeding, infection, hematoma or blister at dressing site. 30.7% (8/26) patients of KWH, 32% (16/50) patients of POH, 14% (7/50) patients of NDH and 44% (22/50) patients of TWH were reported of mild bruise. 3% (1/26) patients of KWH, 6% (3/50) patients of POH, 14% (6/50) patients of NDH and 0% (0/50) patient of TWH were reported of skin redness and itchiness which is related to the type of dressing products and the time of starting bathing. The compliance rate of starting bathing was 92% (24/26) in KWH, 86% (43/50) in POH and 98% (49/50) in NDH and 66% (33/50) in TWH. Conclusion: Different methods can achieve patients’ safety in view of no severe complication. Skin condition and time to start bathing is affected by different dressing products. However, the compliance to start bathing relies on patients’ perception of care. Hence, enhancement on patients’ education and selection of appropriate dressing materials will promote safety of the procedure, maintain patients' personal hygiene and avoid skin problem.

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