New surgery protocols could see kids with appendicitis coming home sooner

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21 April 2017

Managing the treatment of appendicitis using more efficient surgery protocols could mean your child being sent home a day sooner to recover, according to a study featured in the latest issue of the Australia and New Zealand Journal of Surgery (ANZJS), the peer-review publication of the Royal Australasian College of Surgeons (RACS).

A case control study conducted by researchers from the Adelaide Women's and Children's Hospital and the University of Adelaide concluded that implementation of a criteria-led discharge protocol (CLD) would decrease length of stay, incur significant cost savings and safely rationalise medication for uncomplicated appendicitis in children.

The study, which focused on the variation of healthcare across local, regional and international scales among high volume surgical pathologies was conducted from August 2015 to February 2016 and compared outcomes for 83 enrolled patients against a historical group from the previous year.

Key protocol components included limiting post-operative antibiotics, avoidance of intravenous analgesia and better autonomy of nursing staff.

Outcomes of the study suggest that by introducing a CLD, there was nearly a 30 per cent reduction in post-operative length of stay, there was no significant complication rate and 46 per cent less administration of oral morphine than that of the historical group.

Changes in communication were an unexpected bi-product of the study, which researchers said contributed to the study's success. A revised communication approach that began at the time of diagnosis saw patients and parents being counselled, advised of anticipated length of stay and informed of the post-operative process.

This transparency of information allowed parents to better plan arrangements for discharge and eliminated opportunities for ambiguity or misinterpretation.

The study also saw a collaboration between clinical staff, with anaesthetists and surgeons making decisions together, based on the CLD approach.

Read the full article here

The ANZ Journal of Surgery, published by Wiley-Blackwell, is the pre-eminent surgical journal published in Australia, New Zealand and the South-East Asian region for the Royal Australasian College of Surgeons. The Journal is dedicated to the promotion of outstanding surgical practice, and research of contemporary and international interest. 

 

 

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