Audit of 'surgery in general' in an African teaching hospital

A 1-year prospective audit of 2233 operations performed by one general surgical unit in a Central African teaching hospital is presented. In addition to the usual 'general surgical' procedures, operations also included emergency craniotomy, reconstructive surgery for open fractures, and hysterectomy. There were 37 (1.7%) postoperative deaths and 45 other deaths in non-operated patients. Ten of 14 deaths due to sepsis in the 20-40-year age group were associated with HIV infection. The implications for teaching and training of surgical specialists in the tropics are discussed.