Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures?A cross-sectional survey of United Kingdom surgeons  

作　　者：Amber Berry Linzy Houchen-Wolloff Natalie Crane David Townshend Robert Clayton Jitendra Mangwani 

机构地区：[1]Department of Physiotherapy,Spire Hospital,Leicester LE22FF,United Kingdom [2]Department of Physiotherapy,University Hospitals of Leicester NHS Trust,Leicester LE39QP,United Kingdom [3]Department of Orthopaedics,Northumbria Healthcare NHS Foundation Trust,North Sheilds NE298NH,United Kingdom [4]Department of Orthopaedics,Victoria Hospital,Kirkcaldy KY25AH,United Kingdom [5]Academic Team of Musculoskeletal Surgery,University Hospitals of Leicester NHS Trust,Leicester LE54PW,United Kingdom

出　　处：《World Journal of Orthopedics》2023年第4期248-259,共12页世界骨科杂志（英文版）

摘　　要：BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case.This could have significant benefits for patients and the health service.However there are theoretical concerns about post-operative complications and patient satisfaction due to pain.AIM To scope the current practice of foot and ankle surgeons on day-case surgery for major foot and ankle procedures in the United Kingdom(UK).METHODS An online survey(19 questions)was sent to UK foot and ankle surgeons via the British Orthopaedic Foot&Ankle Society membership list in August 2021.Major foot and ankle procedures were defined as surgery that is usually performed as an inpatient in majority of centres and day-case as same day discharge,with day surgery as the intended treatment pathway.RESULTS 132 people responded to the survey invitation with 80%working in Acute NHS Trusts.Currently 45%of respondents perform less than 100 day-case surgeries per year for these procedures.78%felt that there was scope to perform more procedures as day-case at their centre.Post-operative pain(34%)and patient satisfaction(10%)was not highly measured within their centres.Lack of adequate physiotherapy input pre/post-operatively(23%)and lack of out of hours support(21%)were the top perceived barriers to performing more major foot and ankle procedures as day-case.CONCLUSION There is consensus among UK surgeons to do more major foot/ankle procedures as day-case.Out of hours support and physiotherapy input pre/post-op were perceived as the main barriers.Despite theoretical concerns about post-operative pain and satisfaction this was only measured by a third of those surveyed.There is a need for nationally agreed protocols to optimise the delivery of and measurement of outcomes in this type of surgery.At a local level,the provision of physiotherapy and out of hours support should be explored at sites where this is a perceived barrier.

关 键 词：Day-case FOOT ANKLE PHYSIOTHERAPY Survey 

分 类 号：R687.3[医药卫生—骨科学]