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n South African Journal of Surgery - Understanding the reasons for delay to definitive surgical care of patients with acute appendicitis in rural South Africa : general surgery

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Abstract

Appendicitis in South Africa is associated with prolonged delays to definitive surgical care and significant morbidity due to intra-abdominal sepsis. This is a directly causal relationship, as delayed source control has repeatedly been shown to be the variable most closely associated with poor outcomes from intra-abdominal sepsis. Strategies and quality improvement interventions designed to reduce the morbidity associated with acute appendicitis must attempt to reduce delays to definitive care. However, there is a paucity of research on the reasons for these delays. If the treatment of appendicitis is thought of as a process of care, there are a number of distinct areas or domains within the process where delay can be experienced. There may be a significant delay between the onset of symptoms and the patient making contact with the healthcare system. Once the patient has made contact with the system, further delays can be experienced. These include delayed recognition of the need for surgical care and subsequent logistical delays in transferring the patient to the regional hospital. This audit quantifies the delay to definitive surgical care of acute appendicitis in our system and attempts to increase our understanding of where in the process of care the delay was experienced and the factors that contributed to delay in each area or domain. It is hoped that this information may allow for the development of targeted quality improvement programmes.

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/content/m_sajs/52/1/EJC150092
2014-02-01
2016-12-05
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