Outpatient consent practice for varicose vein surgery

Azzam Al-Amin, Muhammad Faiz Taib, Yousif Aawsaj, Asad Rahi

East Lancashire Healthcare Trust, Department of Vascular Surgery, Royal Blackburn Hospital, Blackburn, United Kingdom

Background: The aims of this study were to assess the accuracy and completeness of current consent practice in an outpatient clinic for open and minimally invasive varicose vein surgery, and to ascertain the type of complications suffered by patients and their correlation with consent practice.
Methods: This was a retrospective analysis of outpatient consent practice from January to December 2010. All patients undergoing varicose vein surgery by open or endovenous laser therapy under a single consultant were identified. Case notes were examined by looking at clinic letters and consent forms, which were assessed against current standards.
Results: Over 12 months, 103 consecutive patients were analyzed, and comprised 69 undergoing open surgery and 34 undergoing endovenous laser therapy. In total, 91% of patients were consented by a consultant, 6% by a senior house officer, and 3% by a registrar. For open surgery, all patients were consented for bruising, infection, numbness, nerve damage, and deep vein thrombosis. Only 43% were consented for pain; 2.76% were suffering pain and 6% were consented for thrombophlebitis without suffering. All patients who underwent endovenous laser therapy were consented for pain, numbness, skin discoloration, thrombophlebitis, nerve damage, and deep vein thrombosis. Only 8.8% were consented for infection and 2.9% suffered. No patients were consented for skin burns.
Conclusion: Different strategies should be considered to improve the consent process and avoid the withholding of apparently trivial but crucial information during consenting.

Keywords: consent, litigation, outpatient, varicose veins