Sajeed Ali
Introduction
We aimed to report advice provided after common paediatric surgical procedures including return to education and physical activity.
Methods
Multicentre prospective UK observational study of advice provided by surgeons post-operatively over two-week period. Outcomes of interest: whether advice was provided, method of this and its content.
Results
Across 9 centres, 101 children included (n=28 orchidopexy, n=25 inguinal herniotomy/PPV ligation, n=16 scrotal exploration, n=15 circumcision/preputioplasty, n=9 laparoscopic inguinal-hernia repair, n=5 umbilical/epigastric hernia repair, n=3 laparoscopic appendicectomy). 85/101 male children, with median age 6 years (range 4 months–17 years).
Post-operative advice was provided by a consultant (n=25), registrar (n=55), FY2/SHO (n=17), or FY1 doctor (n=1). Overall, 25% children received verbal advice only, 7% received written advice (e.g. discharge summary/leaflet), and 66% had both verbal and written information. 2% received no post-operative advice.
There was broad variation of advice provided, including on duration of regular analgesia, time to first shower/bath/swim, time to contact/non-contact physical activity, and time before restarting nursery/school.
Regarding return to nursery/school, following groin surgery, 8/53 children were advised 1-3 days off, 17/53 advised 4-6 days, 5/53 advised 1-2 weeks and 20/53 received no advice. Following circumcision/preputioplasty, 3/15 children were advised 1-3 days off school, 6/15 advised 4-6 days, 6/15 received no advice. Similar variation is seen across procedures.
Conclusions
Variation in post-operative advice provided is demonstrated, highlighting surgeon uncertainty regarding optimal post-operative care. Better evidence is required to allow adequate recovery balanced against minimising impact to the family.
Authors
Sajeed Ali
Royal Alexandra Children's Hospital, Brighton, United Kingdom
Imogen Seago
North West Anglia NHS Foundation Trust, Peterborough, United Kingdom
Paediatric Surgical Trainees Research Network PSTRN
PSTRN, Multi-Centre, United Kingdom