Skin Neoplasms Clinical Trial
Official title:
Effects of Visualization of Pre-operative Defects on Patient Satisfaction After Facial Reconstruction for Skin Cancer Resection.
The purpose of this study is to assess the effects of visualization of skin cancer resection defects on the face on the post-operative satisfaction of patients after their reconstruction. To achieve this aim, patients invited to participate in this study will be randomized to either seeing or not seeing their skin cancer excision defect prior to reconstruction. After reconstruction, patient satisfaction will be assessed in both groups to determine if visualization of the defect prior to reconstruction has any effect on patient satisfaction and if any detected effect has durability over time.
Purpose:
The purpose of this study is to assess patient satisfaction after reconstruction of Mohs
skin cancer resection defects in the face, with the resection defect either seen or unseen
by the patient. In this way, the investigators will determine the effects of visualization
of the pre-operative defects on patient satisfaction after facial reconstruction. Any
effects on patient satisfaction that are identified will then be tracked over time.
Hypothesis:
The null hypothesis for this study is that patient satisfaction after reconstruction of Mohs
defects on the face is unaffected by the opportunity to visualize the defect prior to
reconstruction, and that this observation persists over time. Furthermore, patients are able
to recall the size of their cancer resection defect as accurately from a detailed
description as from seeing the defect in a mirror.
Justification:
This study will address whether visualization of a defect prior to its reconstruction
affects patient satisfaction. Visualization of a defect prior to reconstruction is not
standardized and is occasionally, but by no means necessarily, a portion of their consent
for the reconstruction procedure. For the excision and reconstruction procedure in this
study, all patients will be receiving the gold standard treatment for skin cancer. This
includes a Mohs excision of their cancer and subsequent reconstruction of the excision
defect using either primary closure or local flaps. Alternative treatments to this approach
include various forms of excision and reconstruction where cancer free margins cannot be
immediately determined.
Objectives:
The objectives of this study are to determine whether visualization of a cancer excision
defect on the face, prior to its reconstruction, improves post-reconstruction patient
satisfaction. The satisfaction measures sought will primarily be satisfaction with the
cosmetic result but will also include measures pertaining to symptomatic scarring, skin
related quality of life and ability to recall defect size will also be collected.
Research Method:
Patients meeting research criteria will be recruited to this study. These patients will all
undergo cancer excision and reconstruction of the skin cancer defect during the same clinic
visit. After their cancer excision is complete, they will be and randomized to either
viewing or not-viewing their skin cancer excision defect prior to its reconstruction. After
reconstruction they will be provided a series of surveys that assess the research questions
posed by this study. Surveys will be distributed in the clinic on the day of surgery and at
routine follow-up appointments at one week and two to three months.
Statistical Analysis:
The planned sample size for this study is eighty patients randomized to two groups of forty.
Study end points will be sought from patient answers to three sets of surveys that determine
patient satisfaction with the cosmetic appearance of their reconstruction, ranked on an
ordinal scale, as a primary end-point. Secondary end points using ordinal and binary
measures will also be sought and include skin related quality of life (as measured by the
Skindex 16), scarring, and the ability to accurately recall the size of the skin cancer
excision defect. A chi-squared analysis of the data will be performed.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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