Experience with day-care surgery in a Private Surgical Clinic

A retrospective study of 251 operations carried out in a private surgical consultation clinic in Nakuru, Kenya was undertaken. A review was carried out of the clinical notes of patients who had surgery at this clinic between Jan. 1993 and June 1998 and who were regularly followed up to their formal discharge from the clinic. The records were analyzed for age, sex, type of operation, the anaesthetic used, the post-operative analgesics prescribed and post-operative complications. There were 75 (30%) excisions or biopsies of masses or malignancies, 50 (20%) surgical toilets and suture of wounds, 39 (15.5%) incisions and drainage of abscesses, 24 (9.5%) reductions of fractures, 15 (6%) anal operations and 14 (5.5%) inguinal hernia repairs. Postoperative wound sepsis developed in 82 (32.65) of the patients. The study confirmed that in a suitably located, well-organized and adequately equipped surgical consultation clinic, a wide range of carefully selected surgical operations can be safely carried out mainly under local anaesthesia but occasionally with added sedation. Adequate anaesthesia can be achieved in over 70% of the operations and post-operative pain can be effectively controlled using NSAIDs with or without narcotic analgesics. Systemic toxicity though uncommon, is the most serious anaethetic complication. The main post-operative complication is wound sepsis