Abstract
Background:
Developing a successful outpatient service for Ilizarov frame removal provides both patient and cost benefits. Misinformation and patient trepidation can be detrimental to recovery and influence choices. Education may play an important role in tailoring an efficacious service.
Objective:
Review Belfast Regional Limb Reconstruction frame removal practice, introduce changes aimed at improving care and evaluate effects.
Methods:
1 year retrospective review of Ilizarov frame removal. Evaluation of service prior to and following provision of a new patient information leaflet, alongside a test wire removal technique. Subsequent service evaluation supplemented via patient reported feedback questionnaire.
Results:
Retrospectively 85% Ilizarov frames removed in clinic, 54% required Entonox. Annual cost £19000. 46% patients unaware of process, gathering information from unprofessional sources. General anaesthetic and analgesic requirements related to psychosocial influences; no correlation between fracture configuration, elective reconstructive cases and operative techniques. Prospectively 96% patients found information leaflet educational and beneficial. 87% Ilizarov frames removed in clinic. 100% patients who had outpatient removal recommend this method. Entonox use reduced to 15% with average pain score 4.6/10 without analgesia. Patients felt happier. Projected annual cost savings £3000. 100% rated service excellent.
Discussion:
Professional education and a standardised outpatient removal process for Ilizarov frames, delivered by a dedicated specialist team, reduces morbidity and positively impacts service provision.
