Doctor hits at delays in surgery

A SHORTAGE of operating theatres means some Queen Mary Hospital accident victims are waiting for up to 24 hours before surgery, according to a senior doctor.

Orthopaedic surgery head Professor John Leong Chi-yan said delays of 10, 15 and even 24 hours were common for trauma patients who had injuries which were serious - such as a broken leg with an open wound - but not life-threatening.

Professor Leong said there was ''a lack of operating time for non life-threatening trauma victims''.

He said the issue was not simply one of building more operating theatres.

''It is a problem of resources and manpower,'' he said. ''We need more anaesthetists, for example.'' Professor Leong said because Queen Mary Hospital did not have a separate theatre for such patients, they had to join a queue for surgery - and could be pushed further down the queue if an emergency case needing an immediate operation arrived.

''Of course you will not die because of this, but you will have problems,'' he said.

''First of all, the pain and suffering of the patient during that period is itself unacceptable.'' The delays meant surgeons were faced with a more difficult task in operating, he said.

A fractured elbow could be left for two hours without complications, for example, but after five hours the surrounding tissue began to swell, making surgery more problematic.

Professor Leong said delays in surgery also meant the patient suffered more problems in recovery because they increased the likelihood of stiffness, complications and infections, particularly in the case of patients with open wounds.

Patients also suffered discomfort because they had to fast before surgery and even if their operation was delayed for 15 hours, still could not eat as the anaesthetists would refuse to accept them for another six hours.

Professor Leong said his department received about 20 new patients each day, of which about 10 fitted into the category of non life-threatening trauma cases.

''It is difficult to measure the consequences of this,'' he said. ''This is not measurable, deaths are measurable.'' The problem was more acute, however, for elderly patients with fractures who also faced delays of up to two weeks before undergoing surgery, he said.

Such patients had to take second place to the more urgent trauma cases involving open wounds but the delay could bring serious complications for the elderly.

''If you have old people lying in bed for that time, it creates heart and lung problems,'' he said.

This often meant these elderly patients had to stay in hospital for a longer period to be given after-care to correct the problems caused by the delay.

Professor Leong said the hospital was thinking of applying for more funding from the Hospital Authority in 1994/95 to set up a separate operating theatre for non life-threatening trauma cases.

Queen Mary Hospital co-ordinator of clinical services Dr Damon Choy Tack-kong said the hospital understood Professor Leong's concerns but space and resource constraints meant it could not allocate more operating theatre sessions to the Department of Orthopaedic Surgery.

The department already had the second biggest allocation of operating theatre sessions - eight per week - after the Department of Surgery, which had a bigger patient load.

Dr Choy said the problem was exacerbated at present because three floors of operating theatres in the old block were closed while the building was renovated.

They would gradually reopen next year, he said.

''You can be assured [non life-threatening trauma] patients don't have to wait more than a day for surgery,'' he said.