In Practice

Provision of acute and elective general surgical care at a tertiary facility in the era of subspecialisation

J H Klopper, S Rayamajhi, J J Venter, D J de Villiers, N Almgla, J C Kloppers

Abstract


Background. The need for an acute care and general surgical unit (ACGSU) to provide care for patients previously managed on an ad hoc basis by subspecialist units was recognised by the provincial government of the Western Cape Province, South Africa, the management of Groote Schuur Hospital (GSH) and the Department of Surgery.

Objective. To describe the resulting ACGSU and its functioning.

Methods. Data available from administrative records, patient files and operating room forms were collected in spreadsheet form for the period July 2013 - November 2016 inclusive.

Results. The ACGSU comprised a medical care team of four consultants and four to five trainees. A total of 7 571 patients were seen during the study period, the majority (66.1%) referred from the GSH Emergency Centre. Skin and soft-tissue infections formed the major disease complex. A total of 3 144 operative records were available. The most common procedures were wound debridement and inguinal hernia repairs. Trainees acted as primary surgeon in most cases. Complications (Clavien-Dindo grades I - V) were noted in 25.0% of patients.

Conclusions. The ACGSU provides patient management that would otherwise complicate care in the subspecialist surgical units. It serves as a training ground for registrars and stands as a model for other institutions. Further research into the effect on patient care is planned.

 


Authors' affiliations

J H Klopper, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

S Rayamajhi, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

J J Venter, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

D J de Villiers, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

N Almgla, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

J C Kloppers, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa

Full Text

PDF (86KB)

Keywords

Surgery; Emergency; Elective; South Africa; Groote Schuur Hospital

Cite this article

South African Medical Journal 2017;107(11):948-951. DOI:10.7196/SAMJ.2017.v107i11.12335

Article History

Date submitted: 2017-10-31
Date published: 2017-10-31

Article Views

Abstract views: 467
Full text views: 237

Comments on this article

*Read our policy for posting comments here