Orthopedic Day-case Surgery in Nigeria: A Single-center Experience

Echezona Valentine Malizu,1 Omolade Ayoola Lasebikan,2 Njoku Isaac Omoke3

1Rehoboth Specialist hospital, Port Harcourt -Rivers state, Nigeria

2National Orthopaedic Hospital, Enugu- Enugu State

3Department of Surgery, Ebonyi State University/ Federal Teaching Hospital, Abakaliki- Ebonyi State, Nigeria

Correspondence to: Dr Isaac Omoke, E-mail: zicopino@yahoo.com

Received: 26 August 2019; Revised: 31 March 2020; Accepted: 01 May 2020; Available online: 25 May 2020

 

Abstract

Background: The concept of day-case surgeries is relevant in orthopedic specialty in developing countries, where orthopedic elective procedures have relatively longer duration of surgical waiting time, mainly due to lack of inpatient bed space. We aimed to determine the scope, safety and outcome of orthopedic day-case surgeries in a Nigerian setting, and identify potential areas for intervention to improve the practice. Methods: This was a 12-month prospective study of 71 eligible, consenting and consecutive patients who presented at the National Orthopedic Hospital Enugu and were carefully selected and prepared for orthopedic day-case surgeries. Results:  Within the period of study, 53 of 540 elective orthopedic procedures were carried out as day-case, giving a day-case surgery rate of 9.8%. Of the patients enrolled, male to female ratio was 1.2:1 and age range was 8 months to 76 years. Eighteen (25.4%) patients had their day-case procedure cancelled on the day of surgery. The commonest procedure was removal of implant. Conversion rate was 32% mainly due to operation occurring late. Complication (mainly pain) rate was 30%, and correlated with duration of procedure (p<0.006). The satisfaction rate among patients was 98%; no re-admission or mortality was observed. Conclusion:  In this study, orthopedic day-case procedures were safe, though there was low use of day-case surgery in scope, complexity and number of procedures. This and the high conversion rate observed call for a dedicated day-case unit and measures to facilitate timelines of the procedures.

 

Keywords: Orthopedics, Day-case surgery

Ann Afr Surg. 2021; 18(1):52–58

DOI: http://dx.doi.org/10.4314/aas.v18i1.10

Conflicts of Interest: None

Funding: None

© 2021 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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