Recall Activity: What Happens Before and After Basal Cell Carcinomas’ Surgery?

We performed one of the most extensive study in scientific literature (3,957 excisions, 2,358 patients) about basal cell carcinoma (BCC) focusing on the behavioral patterns,1 the risk factors associated to incomplete excisions,2 and the following preferred surgical management.2 The data about each patient and each surgery were carefully organized in a Microsoft Office Excel 2003 (Microsoft Corporation, One Microsoft Way, Redmond, WA 98052-6399 USA) database. The long time lapse (from January 1992 and September 2007) of the study and the huge number of considered variables (gender, age at first intervention, months waited by the patient before undergoing a plastic surgeon’s examination, date of biopsy when performed, histological subtype after biopsy, depth of infiltration after biopsy, date of surgery, anatomical site, size, surgical technique of repair, histological subtype after surgery, depth of infiltration after surgery, complete vs incomplete excision, margins involvement, multiple lesions treated in the same surgical session, and primary vs recurrent BCC) unavoidably lead to spotted missing information of our database, due substantially to desultory incomplete clinical folders. Furthermore, patient clinical folder does not include post-surgical treatment (chemotherapy, radiotherapy, etc) and surgery performed in other hospitals. We resolve to undertake the Recall Activity, which consist in phoning and questioning all the patients that have been taken into care by Plastic Surgery Department of Riuniti Hospital in Bergamo (Italy), to decrease the number of the omitted data. Accordingly to our knowledge, the scientific literature does not provide any other example of Akin task with this purpose. During the review of patients’ clinical folders, we set aside a column to gather their respective telephone number that we found on the frontispiece. We collected the phone numbers (2,358) of all the patients who had undergone BCC excision (one or more) at Plastic Surgery Department of Riuniti Hospital in Bergamo (Italy) between January 1th, 1992 and August 31th, 2007. The Recall Activity started on December 1th, 2007 and took about seven weeks in which the phone calls were made continuously between 8.30 a.m. and 7.00 p.m. by the same person (Codazzi). After a first round of phone calls, we proceeded with a second round trying to contact patients who did not answer at first instance. We administered the same questionnaire to each patient with this approach: (i) Personal presentation of the interviewer (Codazzi); (ii) Explanation of the reasons of the call; and (iii) 1. Department of Plastic Surgery, University of Turin, San Giovanni Battista Hospital, Turin, Italy 2. Department of Plastic Surgery, ASST Monza – San Gerardo Hospital, Monza, Monza-Brianza, Italy 3. Department of Plastic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy