THE UNCOOPERATIVE MALE PATIENT

While doing a recent retrospective chart review of over 200 rhinoplasty patients (female:male ratio of 2:1) in a study for one particular technique utilized in a 10-year period, one author (RWHK) noted serendipitously that the male patients to a significant degree were the least likely to make their follow-up appointments in the short and long term. As a group they also were the least likely to follow their written postoperative instructions, which were always reiterated verbally several times preoperatively and postoperatively by both physicians and nursing staff. Often, these patients did not apply intranasal ointment several times a day and came in with dried and crusted nostrils. Worse yet, many did not heed postoperative requirements not to engage in vigorous athletic exercise for several weeks after surgery. A few actually injured their noses in the early postoperative period. These findings are not isolated and are echoed by Sheen and Sheen²²:

But the problems they pose are not proportionate to their number . . . Men ignore their postoperative instructions; they blow out their packing and braise themselves in hot sun. Their dressings fall off. They are intolerant of discomfort, and syncope is far more common than with women.

As surgeons we know how important postoperative patient compliance is and therefore with our male patients we must provide written instructions and be quite emphatic preoperatively to be sure that they read, understand, and promise to follow these instructions as well as agree to return for scheduled appointments.

REFERENCES

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