Paediatric day care surgery: a hidden burden for primary care?

The aims of this study were to identify prospectively 'concealed' postoperative problems, to assess the burden of paediatric day care surgery on primary care services and to define a normal recovery period for common children's procedures. At their first postoperative clinic visit, patients and parents were asked directly about postoperative problems, unscheduled contacts with the hospital or other health professionals, and the time taken to resume normal activity and return to school. A total of 651 children, median age 4 years (range 0-16 years) were included. Median time to the first clinic appointment was 42 days (range 4-235 days). There were 100 unscheduled postoperative contacts (15.5% of all episodes) of which 81 were with general practitioners. Most problems recorded were relatively minor, and most requiring major intervention were identified before the child left hospital. There was a very high incidence of wound related problems after circumcision. Most children were 'back to normal' within a few days (median 2 days, range 0-30 days) and back to school within a week (median 6 days, range 1-20 days). There was a high rate of primary care contact despite clear written and verbal advice given in hospital and the offer of open access for any concerns. Recovery from day care surgery was rapid and overall level of patient satisfaction was high.