AbstractsMedical & Health Science

A retrospective audit of trauma surgery at a level 1 trauma centre in South Africa

by A. H. Chowdhury

Institution: University of Cape Town
Degree: MS
Year: 2014
Keywords: Med
Record ID: 1411898
Full text PDF: http://hdl.handle.net/11180/9618


Includes abstract. Groote Schuur Hospital Trauma Centre (GSHTC) in Cape Town has a role to play in the prevention and mitigation of trauma through the propagation of quality treatment and fulfilling the aim of the World Health Organization (WHO) declaration on emergency care for the injured. An examination of the trauma services at a level-1 Trauma Centre using best care principles as a means of accessing and improving the current trauma system. A retrospective review of patients admitted to the trauma surgical ward (C5) over a 4-month period. A total of 300 patients were admitted to trauma surgery ward. The mechanism of trauma was stab wounds in 204 (68%), 73 with GSW’s (24.3%), and 23 (7.7%) blunt injuries. Two-hundred and seventy-nine (93%) patients were transported by Emergency Medical Services (EMS). The ISS was >15 in 49%. The median delay for arrival at GSH from scene, Community Health Clinic (CHC), and secondary hospital were 1.5, 5 and 5.8 hours respectively (p < 0.001). The delay from injury to theatre was a significant factor in the development of complications. Seventy-two cases (60%) of abdominal trauma were managed non-operatively (p <0.001). Of 33 GSW abdomen 24 (72.7%), and of 18 Blunt abdominal trauma only 3 (16.7%) patients required surgery. The median stay was 3 days and 12 days for patients that developed complications (p<0.001). Only two patients died (0.7%). Penetrating trauma continues to be a major burden on the resources of a Trauma Centre. There were delays in the transport of patients from the smaller hospitals and the direct trauma referral system needs to be strengthened. Non-operative management of abdominal trauma is a very important component of trauma surgical care and is decreasing the operative load on the theatres.