Day Surgery safer than an overnight hospital stay

Many plastic and cosmetic surgery procedures such as breast implant surgery, breast reduction, nose surgery, facelift surgery, eyelid surgery liposuction and tummy tuck surgery are now done as Day Surgery. This means that patients arrive in the morning, have their operation, and then go home in the afternoon.  However, this was certainly not the case when Avenue Day Surgery was established 20 years ago in 1991. At that time, if you were having one of the above procedures, it was common to spend several days in hospital. In those days, the question was whether Day Surgery could be as safe as surgery involving a hospital stay. It soon become clear that Day Surgery was actually a lot safer than staying even a single night in hospital. Recent research (due for publication the US Journal “Medical Care” (and reported in The Age recently) found that the longer patients stayed in hospital the more likely they were to suffer a range of adverse events considered preventable with optimal care.

The research found that even a 1 night stay in hospital carried a 3.4% risk of an adverse drug reaction, an 11.1% risk of an infection and a 0.4% chance of an ulcer.

For a 5 night stay the risk of a hospital acquired infection increased to 17.6%!

These findings are all the more relevant to patients undergoing plastic and cosmetic surgery as these patients are healthy to start with and do not wish to be made ill as a result of their surgery! The problem with hospitals is that they have to treat a wide variety of conditions. Many patients are ill with infections and these infections are easily transmitted to other patients due to substandard hygiene.

These days, many hospitals employ agency staff who may not be familiar with the special needs of patients undergoing plastic and cosmetic surgery. This is why there is such a high probability of patients suffering a drug reaction. A common adverse drug reaction is nausea and vomiting caused by the administration of pain relieving drugs such as Pethidine and Morphine. If required, these drugs must be administered with the utmost of care as some patients are very sensitive to the drugs and will suffer nausea and vomiting after even a very low dose. Nursing staff in large hospitals just don’t have the time (and often don’t have the expertise), to administer these drugs appropriately.

At Avenue Day Surgery, we have been performing the entire range of plastic surgical procedures including breast implant surgery, breast reduction, nose surgery (rhinoplasty) facelift surgery, liposuction and abdominoplasty with complete safety as a Day Case for 20 years. Day Surgery is simply a different system of care. Over the years we have developed protocols that ensure patients recover from their operation in the shortest possible time. The anaesthetic is, of course, critical and we are fortunate to have two of Melbourne’s top anaesthetists work with us. We have dedicated theatre and recovery nursing staff with the expertise and the time to finesse your care so that you will feel well enough to go home by mid or late afternoon.

Of course it is essential that you have a carer stay with you that night and that your carer is fully briefed about the medication that you have been prescribed. As the patient, all you need to do is rest in bed. Most patients find that they sleep much better in their own bed at home and they find that the whole experience is a lot less stressful than an overnight stay in hospital.

All patients are seen the following morning when dressings are checked and the medication reviewed.Healing and recovery then continue in their safe home environment. It is extremely rare to acquire an infection in these circumstances or to have an adverse drug reaction.

Do any patients stay overnight? Of course they do. For example, patients who do not have a carer, patients from out of town who prefer an overnight stay to staying in a motel and, occasionally, patients having multiple procedures or who feel they may not be able to manage at home.

So, although overnight stay is always an option, for most patients spending the first night after surgery in your own bed at home is a safe and comfortable option.