Surgery: Get Up & Get Out

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Convalescence, once a slow and leisurely period, keeps getting shorter. For highly practical reasons, surgeons continue to cut down the time their patients spend recuperating in the hospital. For one thing, the faster a patient goes home, the less likely he is to pick up a secondary infection from others in the hospital. For another, home atmosphere is considered more conducive to healing in many cases. Most pressing these days is the scarcity of hospital beds. The shorter the average hospital stay, the faster a bed becomes available to others.

Last week, in the A.M.A. Journal, Drs. Arthur Innes, Arline Grant and Malcolm S. Beinfield of the Norwalk (Conn.) Hospital reported that they have further shortened the average postoperative hospital stays in four types of cases:

> Appendectomies, which usually require seven days, now take 3.6 days at Norwalk.

> Gall-bladder removals, normally twelve days, have been cut to 8.4 days.

> Hernia operations, once three weeks, now require 3.6 days.

> Hemorrhoidectomies, once a week or more, are down to 4.2 days.

Earlier, in the journal Surgery, Dr. Paul T. Lahti told of 611 consecutive patients he sent home even more speedily from the William Beaumont Hospital in Royal Oak, Mich., and Grace Hospital in Detroit. Of 67 appendicitis patients, only seven stayed in the hospital even as long as the average Norwalk patient. All 87 of his young single-hernia patients were sent home within two days of their operations. Of 72 gall-bladder convalescents, 59 were out in five days.

All of Lahti's patients went to his office after a few days for removal of stitches, but there were only two hospital readmissions for minor complications. "There has been," says Dr. Lahti with evident relief, "a surprising lack of telephone calls although each patient is advised to call at any time if he has any questions or problems."