Ross Katie, Glazebrook Haley, Douglas Jo-Anne, MacLellan Justin, Krauss Emily M
Division of Plastic Surgery, Department of Surgery, Dalhousie University, Halifax, Canada.
Faculty of Medicine, Dalhousie University, Halifax, Canada.
Plast Surg (Oakv). 2025 Sep 3:22925503251371057. doi: 10.1177/22925503251371057.
Emergency department (ED) visits following elective surgeries place significant strain on already overburdened healthcare systems. In Nova Scotia, carpal tunnel release (CTR) and trigger finger release (TFR) are the most common elective hand surgeries performed. This study sought to determine the rates, reasons, and risk factors associated with ED visits following elective outpatient hand surgery. Patients who underwent CTR or TFR between April 1, 2016 and March 31, 2022, and visited any Nova Scotia ED within 90 days of surgery were identified using provincial healthcare databases. A chart review was completed to explore ED timing, reasons for presentation, and predetermined systems-level factors. During the retrospective period, 2690 patients underwent CTR and 1103 patients underwent TFR. For CTR, 159 patients (5.97%) presented to the ED within 90 days of surgery for surgery-specific concerns. The most common presentation was surgical site infection (2.16%), wound check (1.60%), and suture removal (1.04%). For TFR, 63 (5.71%) patients presented to the ED within 90 days. Similarly, surgical site infection was the most common presentation (2.63%) followed by suture removal (1.45%) and wound check (1.18%). The most frequent timing for ED presentation was days 13-15 (27.9%). In an evaluation of true healthcare utilization after elective surgery, ED visits for surgery-specific concerns after CTR and TFR were nearly 6%, far exceeding expected complication rates. As the presentations are manageable in an outpatient clinic or office setting, a mixed-methods patient-oriented intervention is planned to redirect this population away from the ED.
择期手术后的急诊科（ED）就诊给本就不堪重负的医疗系统带来了巨大压力。在新斯科舍省，腕管松解术（CTR）和扳机指松解术（TFR）是最常见的择期手部手术。本研究旨在确定择期门诊手部手术后急诊科就诊的发生率、原因及风险因素。利用省级医疗数据库识别出在2016年4月1日至2022年3月31日期间接受CTR或TFR手术且在术后90天内前往新斯科舍省任何一家急诊科就诊的患者。完成了一项病历审查，以探究急诊科就诊时间、就诊原因以及预先确定的系统层面因素。在回顾期内，2690例患者接受了CTR手术，1103例患者接受了TFR手术。对于CTR手术，159例患者（5.97%）在术后90天内因手术相关问题前往急诊科就诊。最常见的就诊原因是手术部位感染（2.16%）、伤口检查（1.60%）和缝线拆除（1.04%）。对于TFR手术，63例患者（5.71%）在术后90天内前往急诊科就诊。同样，手术部位感染是最常见的就诊原因（2.63%），其次是缝线拆除（1.45%）和伤口检查（1.18%）。急诊科就诊最频繁的时间是术后第13 - 15天（27.9%）。在对择期手术后实际医疗利用情况的评估中，CTR和TFR手术后因手术相关问题前往急诊科就诊的比例近6%，远远超过预期的并发症发生率。由于这些情况在门诊诊所或办公室环境中是可以处理的，因此计划采用一种以患者为导向的混合方法干预措施，将这部分人群从急诊科分流。
