Day Stay Surgery
The evolution of day stay surgery in Oral and Maxillofacial Surgery (OMFS) is depicted through historical background, reasons for change, current practices, and ways to further improve efficiency. From longer hospital stays to optimizing procedures for same-day discharge, the journey highlights organizational and clinical advancements that have shaped the modern approach to OMFS procedures.
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Presentation Transcript
Day Stay Surgery The background and state of play in OMFS
History History Patients stayed in for simple procedures Removal of wisdom teeth in 1970s = 2 night stay Orthognathic and trauma often 4 or 5 nights
Why? General apathy Organizational Patients admitted day before surgery Lack of preoperative preparation Lack of day case units No bed shortages Specialties wanted to keep their beds full Clinical Pain management Anaesthesia Patients in IMF needed to be able to feed post discharge Management of swelling
What changed Organizational Bed pressures Increased need for financial control in NHS 1985 RCS Guidelines for day case surgery BADS 2002 NHS Plan 75% surgery day stay Clinical Better anaesthesia Better pain control E.g. use of local at operation site Increasing use of steroids in surgery and anaesthesia Better management of bleeding especially in orthognathic surgery Increasing use of rigid internal fixation instead of IMF
So where are we now Majority of dentoalveolar surgery where there is GA is done as a day stay Trusts are beginning to think of OMFS trauma as a day stay procedure Having a drain does not automatically generate an overnight stay Seeds of change in orthognathic surgery However still significant variation
Orthognathic surgery currently day case rates very low room for improvement
SO HOW TO IMPROVE Share ideas Publish Report good practice Webinars! Conference papers and abstracts Show what is possible and safe Patient experience reports
