Day Case Orthopaedic Surgery in a West African Teaching Hospital

Abstract

Background: Day case surgery, carried out in dedicated day care surgery centres, is now very popular all over the world due to the reduced cost and improved safety. Regrettably, in Nigeria, where cost of treatment is a real issue, very few, if any dedicated day care surgery centres have been established. Knowledge of the demographic data of patients and scope of surgical operations performed should provide a basis for the establishment of daycare surgery centres in this part of the world.
Objective: To review the demography and scope of day case orthopaedic surgical operations carried out in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria (LASUTH) where there is no dedicated day care surgery unit.
Materials and Methods: Records of patients who had day case surgery and were discharged within 24 hours of surgery between June 2004 and May 2006 were reviewed. Biographic data, indications for surgery, operations performed, anaesthetic technique used, complications and reasons for unplanned hospital admission were extracted.
Results: A total of 117 patients had day case surgery. There were 60 males and 57 females and the age range was 18 weeks to 76 years. More upper limb surgeries were performed and the commonest procedure was excision biopsy of benign soft tissue tumours (35.1%). Most operations (80%) were performed under local anaesthesia, mainly local infiltration, whilst sphygmomanometer cuffs were used as pneumatic tourniquet when indicated. There were no cases of unplanned hospital admission, anaesthetic or surgical complications.
Conclusion: Day case (ambulatory surgery) can be performed safely in tertiary institutions in Nigeria according to carefully planned protocols. Establishment of dedicated ambulatory centres may enable the performance of more complex surgical operations


Keywords: orthopaedic surgery, day case, ambulatory

Nigeria Journal of Orthopaedics and Trauma Vol. 7 (2) 2008: pp. 57-59