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Early discharge from hospital after open appendicectomy
1Department of Surgery, Royal Berkshire Hospital, Reading, UK.
The British Journal of Surgery
|September 1, 1993
Summary
Early discharge after emergency appendicectomy is safe and well-tolerated. Most patients undergoing appendicectomy can go home within 24 hours with appropriate pain management.
Area of Science:
- Surgery
- Gastroenterology
- Clinical Medicine
Background:
- Appendicectomy is a common emergency surgical procedure.
- Traditional hospital stays following appendicectomy can be lengthy.
- Optimizing postoperative care pathways is crucial for patient recovery and hospital resource management.
Purpose of the Study:
- To evaluate the safety and patient acceptability of early hospital discharge within 24 hours after emergency appendicectomy.
- To assess the need for postoperative analgesia and readmission rates in patients discharged early.
- To identify factors influencing delayed discharge in emergency appendicectomy patients.
Main Methods:
- Prospective study of 200 consecutive patients undergoing open emergency appendicectomy.
- Standard muscle-splitting incision with wound infiltration of bupivacaine and diclofenac suppository administration.
- Patients informed of potential for 24-hour discharge, with follow-up at 2 weeks.
Main Results:
- 147 patients (73.5%) were discharged within 24 hours.
- Only 2 patients required readmission; 12 saw their GP, mainly for wound issues or pain.
- 26.5% of patients were not discharged early due to peritonitis, social reasons, nausea, or other complications.
Conclusions:
- Early discharge within 24 hours after emergency appendicectomy is a safe and effective strategy.
- The protocol demonstrated good patient acceptability with minimal complications.
- Factors such as peritonitis significantly impact the feasibility of early discharge.