• J H Klopper, S Rayamajhi, J J Venter, D J De Villiers, N Almgla, and J C Kloppers.
• Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa. juan.klopper@uct.ac.za.
• S. Afr. Med. J. 2017 Oct 31; 107 (11): 948-951.

BackgroundThe 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.ObjectiveTo describe the resulting ACGSU and its functioning.MethodsData available from administrative records, patient files and operating room forms were collected in spreadsheet form for the period July 2013 - November 2016 inclusive.ResultsThe 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.ConclusionsThe 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.

23 keywords...

hide…