Ambulatory paediatric surgery. The development of a day-care surgical centre.
Ambulatory surgery has become an important component in the provision of surgical care. In 1987 a day-case surgical unit was established at Red Cross War Memorial Children's Hospital, Cape Town. Experience over a 6-year period (1987-1992) is reviewed in relation to the nature and total number of surgical procedures, pre-operative preparation, daily utilisation of the facility, postoperative care and complications. During this period 16,538 patients (mean age 3 years) were operated on in the unit. Nine surgical disciplines participated. Pre-operative assessment and preparation reduced the rate of cancellations on the day of surgery to less than 6%, with a 90% effective use of schedules operating time. Scarce nursing resources were also maximally utilised. Most procedures took less than 30 minutes and only 0.8% exceeded 1 hour. The average ward stay was 6 hours. No major complications were encountered and acceptance by patients and parents was excellent. Only 16 children who were not scheduled to do so needed to stay in hospital overnight. Recommendations to establish and improve day-stay surgical services are presented. It is concluded that a practical, efficient service can be established and that the authorities should be encouraged to expand appropriate facilities.
Rode
H
H
Department of Paediatric Surgery, University of Cape Town.
Millar
A J
AJ
McCormack
D
D
Prescott
C A
CA
O'Leary
P
P
Cywes
S
S
D000556:Ambulatory Surgical Procedures / Q000592:standards* / Q000639:trends; D002648:Child; D003631:Day Care, Medical / Q000379:methods; D006801:Humans; D007430:Intraoperative Care; D018579:Patient Selection; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care; D013019:South Africa