Impact of Surgical Same Day Emergency Care (SDEC) on the Time to Surgery for Zygoma and Mandible Fractures

Introduction: Surgical Same Day Emergency Care (SDEC) opened on July 18th 2022 at the University Hospital of Wales (UHW). It aimed to accelerate the treatment process for acute surgical procedures and allow more day case procedures. The OMFS department manages patients with mandible and zygoma fractures and there were delays to surgical management due to lack of bed spaces. Open reduction internal fixation (ORIF) of the mandible should be done as soon as possible and ORIF of the zygoma should be done before 2 weeks. This service evaluation investigates whether the opening of SDEC had an impact on the waiting times for patients with mandible and zygoma fractures to have surgery.

Method: This is a retrospective service evaluation looking at all patients who presented to UHW with a mandible or zygoma fracture between January 2022 and 2023. I looked specifically at patients who had surgical management. The initial search for patients was done by taking data from TeamTalk and the rest of the data collection was from Welsh Clinical Portal.

Results: 101 patients presented to UHW between January 2022 and 2023 with a mandible or zygoma fracture. Of these, 58 required surgical management. Patients with a mandible fracture had their surgery 3.2 days earlier on average and patients with a zygoma fracture had their surgery 3.4 days earlier on average, after the implementation of SDEC.

Conclusion: The introduction of SDEC to UHW has made a significant improvement to waiting times for patients with mandible or zygoma fractures who need surgical management. However, this evaluation only looks at the management of patients 6 months before and after the implementation of SDEC and it is important to investigate over a longer period. Regardless, SDEC has been shown to have value in reducing the time taken to achieve surgical management.