An audit, literature review and quality improvement project regarding post-operative aftercare of facial lacerations in children

Abstract

Aims & objectives: To evaluate the communication of post-procedural instructions following repair of paediatric facial lacerations and design a post-procedural informative package to streamline and improve patients’ post-operative care. Methods: 1. Quantitative analysis of clinical records of 50 patients who underwent facial laceration repair, to evaluate clinical documentation 2. Informal survey of OMFS staff regarding perceived shortcomings of communicating post-procedural instructions to these patients’ parents 3. Literature review on post-procedure instructions after facial laceration repair. Results: 34% of clinical records had no mention of post-operative instructions given to patient’s parents. 38% had a non-specific mention: “post-operative instructions given”. Specific instructions were recorded as given in between 16-43% of clinical notes. Discussion: These shortcomings were exacerbated by an increase in cases during lockdown and the timing of presentation- majority ‘out of hours’. We designed and implemented a pack to address this - an evidence-based patient information leaflet with an analgesic (Calpol), in collaboration with the hospital pharmacy and Patient Experience team. We noted, importantly, that routine use of Chloramphenicol is not endorsed by NICE. Conclusion: This audit highlighted the importance of heterogeneity of post-procedural instructions and documentation. Our simple intervention eases DCT burden, streamlines care and improves patient outcomes.

Keywords

• Facial lacerations
• Paediatric trauma
• Wound healing
• Wound management