Day-Case Plastic Surgery at a Tertiary Care Health Institution in South West, Nigeria

Abstract

Abstract Background: The concept of day-case surgery was initially very slow in gaining acceptance among surgeons in Nigeria and other developing countries due to widespread scepticism and unfounded apprehension. However, there is increasing adoption of day-case surgery in many developing countries due to challenges with access to the operating theatre and the risks associated with prolonged immobilisation following surgery. The study aimed to profile the indications for day-case surgery on the plastic and reconstructive surgery service at the University College Hospital Ibadan over a 4-year period (2020–2023), identify complications, and determine the readmission rate from such procedures. Materials and Methods: A 4-year retrospective review of day-case surgeries performed on the plastic and reconstructive service of the University College Hospital, Ibadan, between January 2020 and December 2023 was done. The information obtained included the demographic characteristics of the patients, the diagnosis, type of anaesthesia, postoperative analgesic used, complications, and readmission rate following discharge of the patients. The data obtained were analysed using IBM SPSS version 22. Results: A total of 156 day-case plastic surgery procedures were done; this accounted for 24.8% of all the elective plastic surgery procedures done over the year under review. Only 103 case files were able to be retrieved (retrieval rate of 66%). The mean age was 33 years (SD 14.7 years). There were 56 males and 47 females, with a male-to-female ratio of 1.2:1. All patients reside within the Ibadan metropolis. Most of the patients were American Society of Anaesthesiologists (ASA I; 95.1%), while 4.9% were ASA II. The most commonly performed surgery was keloid excision 24 (23.3%), followed by lipectomy 15 (14.6%), ganglionectomy 10 (9.7%), in-growing toe nail procedure 8 (7.8%), pyogenic granuloma excision 7 (6.8%), slit-ear lobe repair 6 (5.8%), epidermoid cyst excision 5 (4.9%), sebaceous cyst excision 4 (3.9%), giant cell tumour excision 3 (2.9%), and others. Local anaesthesia was used in 98.6% of patients. Postoperative complications occurred in seven (6.8%) of patients, with surgical site infection being the most common complication (3.9%). No patient had admission conversion or readmission. No mortality was recorded. Conclusion: Day-case plastic surgery operation is safe with minimal complications in carefully selected patients. The scope of the procedures can further be increased in order to increase the patient’s access to surgery.