Dermatologic Surgery and Reconstruction Photograph Booklet as a Tool to Improve Informed Consent Before Skin Surgery

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Skin surgery is a high-risk area of litigation and tools to improve consent are welcomed.


This project aimed to strengthen the consenting process for dermatological surgery by introducing a photograph booklet.


The authors designed a booklet containing skin surgery images. Patients attending surgery completed an anonymous questionnaire immediately after their procedures before the booklet introduction (Group 1). The questionnaire was then repeated (Group 2) with the introduction of the photograph booklet during consent. The authors looked for changes in the following: understanding of procedure, scar, and postoperative care as well as addressing of patients' concerns using a subjective scale of 1 to 5 (1 = poor, 2 = fair, 3 = okay, 4 = good, and 5 = great).


Results indicated greater patient satisfaction among patients in Group 2 who had been shown relevant surgical images compared with Group 1, with improvements from ratings of 3 and 4 on the scale to 5. The difference in the 2 groups for the highest ratings of 5/5 was significant (p < .05) for understanding of procedure and resulting scars.


The use of photograph booklets containing simple and relevant images to support the consent process for dermatologic surgery improves patients' understanding, expectations, and experience of skin surgery.

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