Day surgery: are we transferring the burden of care?

Day procedures are preferred by many surgeons for minor and intermediate procedures in fit patients. It is however considered to transfer the burden of care to care-givers and other healthcare providers.

The aim of the following study is to assess the tendency of day care patients seeking attention from health care providers and their ability to ambulate in the first week.

Prospective study in a tertiary health facility in South-South Nigeria.

Patients in American Society of Anesthesiologists class I and II undergoing day-care procedures in a surgery unit were assessed at one week for the effects of the procedure on ambulation and their likelihood to seek medical attention. Data on the sex, type of procedure, pain, bleeding and ambulation was analyzed. A visual analog pain score of 0- 3 (mild); 4-6 (moderate) and 7-10 (severe) was used. Bleeding was defined as complete soaking of the two-layered gauze dressing with blood.

Analysis was performed with SPSS 17 for Windows (SPSS Inc. Chicago, Illinois) and presented as percentages, mean and tables.

A total of 99 patients comprised of 47 males and 52 females registered in the study; with a mean age of 38 years (range 16-70); 76 patients (77%) complained of pain at the operation site while 23 (23%) had no complaints. Pain was mild in 59 (78%) and moderate 17 (22%). None had severe pain or bleeding from the operation site; 85 patients (86%) could ambulate easily, 14 (14%) partially and none completely unable to ambulate.

Day procedures in selected patients has minimal affects on their ambulation and no increased risk of seeking medical attention in the first week and would appear not to transfer the burden of care to the community.