Authors (including presenting author) :
Chan WY, SY WM, Yiu MP, Luk W
Affiliation :
Cheung Sha Wan Jockey Club General Outpatient Clinic, Department of Family Medicine & Primary Health Care, Kwoloon West Cluster
Introduction :
Patients presenting with lumps and bumps, trigger fingers, repetitive stress injuries and various dermatological skin conditions requiring skin biopsies are common problems encountered in GOPC. Yet patient who wish to have excisions or various surgical procedures may have to wait for a long time for SOPD services. Minor operation (MOT) sessions were arranged to provide various simple surgical procedures, including lumps and bumps excisions, skin biopsy, steroid injections etc. to meet patients' needs.
Objectives :
- To review patient load and various kinds of MOT done in our clinic
- To review the average waiting time of MOT
- To review the safety and complication rate of MOT done in our clinic
Methodology :
A retrospective review was conducted at CSW GOPC from 1/1/2018 to 31/12/2018. All MOT cases done in our clinic were identified. Nature of the procedure, waiting time, procedure outcomes and complications were reviewed retrospectively.
Result & Outcome :
A total of 74 MOTs were done in our clinic between 1/1/2018 and 31/12/2018. Among them, 41 cases (55.4%) were steroid injections (35 cases of trigger finger, 2 cases of tennis elbow, 2 cases of dequervain tenosynovitis, 1 case of plantar fasciitis and 1 case of keloid scar), 23 cases (31.1%) were excision of skin lumps and bumps, 9 cases (12.2%%) were skin biopsies for dermatological disorders (2 cases were on aspirin); and 1 case (1.35%) was aspiration of wrist ganglion. MOT sessions were mostly performed by our trainees with the supervision of our specialists. USG-guidance was sometimes adopted when performing steroid injections at special locations. Cautery pen was also used at times to help achieve haemostasis. The average waiting time of our MOT ranges from 2 to 13 weeks. Priority would be given according to medical indications. No serious complications (including post-operative bleeding, wound infection and neurovascular damage) were noted or reported after all the MOTs done. Of 23 cases of surgical excision done, only 1 case required subsequent SOPD referral due to incomplete surgical excision / re-growth of the lesion. The rest achieved complete surgical removal with no major complications. 12 out of 41 cases of steroid injections done reported significant improvement of symptoms or complete resolution of symptoms (the outcomes of the rest were not known as no follow-up afterwards). Conclusion MOT done in our clinic were generally safe with a low complication rate. It offers patients an alternative access to simple surgical procedures with a much shorter waiting time to improve patient care. It may also help reduce the SOPD burden by lowering the referral rates.
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