Day surgery for major paediatric foot and ankle procedures.
Jagodzinski NA, Gul R, Khanum S, Prem H.
Birmingham Children's Hospital, Steelhouse Lane, Birmingham, United Kingdom.
drstinski@yahoo.co.ukJ Orthop Surg (Hong Kong). 2011 Apr;19(1):69-71.Abstract
PURPOSE: To review outcomes in 19 children who underwent major foot and ankle procedures as day cases. METHODS: A consecutive series of 24 major foot and ankle procedures in 19 children performed as day cases by a single surgeon were reviewed in terms of the immediate postoperative pain relief, severe swelling (necessitating cast removal), and complications. Parental satisfaction was assessed using a telephone survey with respect to pain relief of the patients, and their views on management as day cases. RESULTS: The 24 procedures comprised tendon transfers (n=18), posterior releases (n=3), and excisions of a tarsal coalition (n=3). During the post-discharge 24 hours, no patient developed complications that entailed hospital services. All parents of the patients were satisfied with the overall service provided. The analgesia prescribed at discharge was sufficient to control pain in 20 out of the 22 procedures. In the remaining 2 procedures (under caudal and general anaesthesia), the parents considered the analgesia insufficient, but did not contact the helpline for advice. One child bled through the bandages to a minor extent. CONCLUSION: Some major paediatric foot and ankle procedures can be safely performed as day cases and achieved adequate analgesia with appropriate advice. More such procedures can be added to the day case list, even on an afternoon list.
http://www.josonline.org/pdf/v19i1p69.pdf 
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