EARLY DISCHARGE FROM HOSPITAL AFTER OPEN APPENDECTOMY

A prospective study of 200 consecutive open emergency appendicectomies was carried out. All patients were informed before operation that they would be discharged the following day if possible. The operation was performed through a standard muscle-splitting incision. At the end of the operation the wound was infiltrated with bupivacaine and a diclofenac suppository was given. There were 29 normal, 129 acutely inflamed, six gangrenous and 36 perforated appendices. In all, 147 patients (73.5 per cent) were discharged home within 24 h and reviewed 2 weeks later. Twelve patients had seen their general practitioner, mainly for wound problems (eight) or pain (two). Two others required readmission. Thirty-four patients (23.1 per cent) required no postoperative analgesia; 104 (70.7 per cent) required paracetamol or co-proxamol for less-than-or-equal-to 3 days and nine (6.1 per cent) for > 3 days. No patient had a problem directly related to early discharge from hospital. Fifty-three patients (26.5 per cent) were not discharged home early due to peritonitis (36), social reasons (seven), nausea (seven), associated caecal volvulus (one) and pregnancy (two). Early discharge from hospital within 24 h after emergency appendicectomy is safe and has good patient acceptability.