LAUSR

To assess confidence and knowledge of managing free flaps in foundation doctors’, who, whilst working on a general surgery rota, are expected to intermittently manage plastic surgery patients, and introduce a simple tool to support them. A single-centre closed-loop quality improvement project, using the ‘Plan, Do, Study, Act’ methodology, was conducted. Initially, a prospective, baseline audit assessing foundation doctors’ confidence and knowledge was carried out. This utilised images and clinical scenarios to assess understanding of complications. Results were analysed, and a simple poster was designed and distributed for reference. Two months later the questionnaire was repeated to reassess confidence and knowledge. Pre- and post- intervention surveys were completed by all general surgery foundation doctors (n = 11). Mean confidence was significantly improved following intervention (p = <0.0001). Baseline ability to spot a healthy flap and venous congestion was good. Ability to identify arterial occlusion and a healthy muscle flap, with concurrent split-thickness skin graft, significantly improved (p = <0.0001 and p = 0.0091, respectively) Foundation doctors lack confidence and knowledge of managing free flaps, despite some being expected to do so whilst on a general surgery rota. This can be improved through a simple, informative resource to refer to when dealing with these patients.