OPTIMIZING DAY-CASE SURGERY IN PAKISTANI HOSPITALS: A COMPREHENSIVE STUDY OF CLINICAL, MICROBIOLOGICAL, AND PHARMACOLOGICAL OUTCOMES
Main Article Content
Keywords
Day-case surgery, postoperative complications, surgical site infections, antibiotic prophylaxis, pain management, Khyber Pakhtunkhwa
Abstract
Background: Day-case surgery is becoming more and more popular throughout the globe since it may save costs and shorten hospital stays. Results, however, might differ, especially in environments with limited resources. The purpose of this research was to assess the pharmacological, microbiological, and clinical results of day-case operations performed in hospitals located in Khyber Pakhtunkhwa (KPK), Pakistan.
Objectives: The purpose of the research was to evaluate the success of pain management procedures in day-case operations, as well as the rates of complications and infections. Finding predictors of postoperative complications was another goal.
Methods: From January to September 2021, four hospitals in KPK participated in a multicenter observational research. Included were 300 individuals having elective day-case operations. Information on microbiological results, pharmaceutical therapies, and surgical complications were gathered. The results of statistical analysis were used to determine important variables that predicted problems.
Results: 4% of patients had surgery site infections, accounting for 9% of total complications. Staphylococcus aureus (65%) and Escherichia coli (20%) were common pathogens. Ninety-two percent of patients received antibiotic prophylaxis, and ninety-two percent reported sufficient pain management. Postoperative complications were significantly predicted by both the length of the operation and the presence of preexisting diabetes. The results did not significantly vary across hospitals.
Conclusions: Day-case surgery results at KPK hospitals were generally good, although focused care for high-risk patients and better infection control are required. The results highlight how crucial strong infection control procedures and efficient pain control are to achieving the best possible surgical results.
References
2. Patel A. Effectiveness of cefotaxime in preventing surgical site infections in children under 8 years undergoing elective inguinal surgery at the university teaching hospitals, Lusaka, Zambia (Doctoral dissertation, The University of Zambia).
3. Mustafa ZU, Khan AH, Salman M, Harun SN, Meyer JC, Godman B, Seaton RA. Healthcare-associated infections among neonates and children in Pakistan: findings and the implications from a point prevalence survey. Journal of Hospital Infection. 2023 Nov 1;141:142-51.
4. Kurdi A, Hasan AJ, Baker KI, Seaton RA, Ramzi ZS, Sneddon J, Godman B. A multicentre point prevalence survey of hospital antibiotic prescribing and quality indices in the Kurdistan regional government of Northern Iraq: The need for urgent action. Expert review of anti-infective therapy. 2021 Jun 3;19(6):805-14.
5. Ogunleye OO, Oyawole MR, Odunuga PT, Kalejaye F, Yinka-Ogunleye AF, Olalekan A, Ogundele SO, Ebruke BE, Kalada Richard A, Anand Paramadhas BD, Kurdi A. A multicentre point prevalence study of antibiotics utilization in hospitalized patients in an urban secondary and a tertiary healthcare facilities in Nigeria: Findings and implications. Expert review of anti-infective therapy. 2022 Feb 1;20(2):297-306.
6. Skosana PP, Schellack N, Godman B, Kurdi A, Bennie M, Kruger D, Meyer JC. A point prevalence survey of antimicrobial utilisation patterns and quality indices amongst hospitals in South Africa; findings and implications. Expert review of anti-infective therapy. 2021 Oct 3;19(10):1353-66.
7. Xia W. Improving Outcomes Following Excisional Haemorrhoidectomy (Doctoral dissertation, ResearchSpace@ Auckland).
8. Jaafar G. Antibiotic prophylaxis and infectious complications in surgery for acute cholecystitis. Karolinska Institutet (Sweden); 2018.
9. Perni S, Bojan B, Prokopovich P. A retrospective study of risk factors, causative micro-organisms and healthcare resources consumption associated with prosthetic joint infections (PJI) using the Clinical Practice Research Datalink (CPRD) Aurum database. Plos one. 2023 Mar 21;18(3):e0282709.
10. O'Connell PR, McCaskie AW, Sayers RD. Bailey & Love's short practice of surgery. CRC Press; 2023 Mar 30.
11. Dahn CM, Wijesekera O, Garcia GE, Karasek K, Jacquet GA. Acute care for the three leading causes of mortality in lower-middle-income countries: A systematic review. International Journal of Critical Illness and Injury Science. 2018 Jul 1;8(3):117-42.
12. Williams NS, O'Connell PR, McCaskie A, editors. Bailey & Love's short practice of surgery. CRC press; 2018 Apr 27.
13. Faisal R, Shinwari L, Aziz I, Khalil AT. Therapeutic and adverse effects of commonly used medicinal plants: Standardization and quality assurance: Adverse effects of commonly used herbs. Proceedings of the Pakistan Academy of Sciences: B. Life and Environmental Sciences. 2019 Sep 12;56(3):1-9.
14. Kon OM, Beare N, Connell D, Damato E, Gorsuch T, Hagan G, Perrin F, Petrushkin H, Potter J, Sethi C, Stanford M. BTS clinical statement for the diagnosis and management of ocular tuberculosis. BMJ Open Respiratory Research. 2022 Mar 1;9(1):e001225.
15. Talkhan H. A mixed-methods study to identify, quantify and explore determinants of antimicrobial prescribing behaviours among clinicians in Qatar (Doctoral dissertation).
16. Affandi S, O'Nunain S. Investigations and management strategies of acute myocardial infarction in young adults (a single centre clinical audit). Clin Med (Lond). 2020 Mar 1;20:s1.
17. Pourhajibagher M, Bahrami R, Bahador A. Application of photosensitive dental materials as a novel antimicrobial option in dentistry: A literature review. Journal of dental sciences. 2023 Dec 25.
18. MacKinnon M. Exploring the burden of disease associated with human Escherichia coli bloodstream infections (Doctoral dissertation, University of Guelph).
19. Budgell EP. Measuring the impact of reduced antibiotic use in hospital settings using electronic health records (Doctoral dissertation, University of Oxford).
20. Mburu JK. Indications and early complications of double–J ureteric stents as seen at Kenyatta national hospital (Doctoral dissertation, University of Nairobi).
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Aligohar Khan
Head of Department, General Surgery, Fauji Foundation Hospital, Peshawar Cantt Pakistan
Muhammad Kamran Khan
Assistant Professor, College of Medicine, Dawadmi
Dr ILyas Fiaz
Pakistan Institute of Medical Sciences, Islamabad Pakistan
Dr Bilquees Saba
Senior Registrar, Consultant Nephrologist, Ziauddin University Hospital, Karachi
Erum Khalid
Institute of Biochemistry and Biotechnology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi
Inam-u-llah
The Department of Food Science and Technology, The University of Haripur.