Plastic surgery minor procedure room: a cost-effective way to operate

Abstract

Introduction: Surgery using local anaesthetic without sedation outside of a formal operating theatre is particularly applicable to plastic surgery. This paper reviews the benefits and pitfalls of a minor procedure room as a novel solution to tackling the emergency and elective surgery caseload in a tertiary metropolitan plastic surgery unit. Methods: From February 2022 until February 2023 local anaesthetic only procedures were undertaken in a minor procedure room. Patients included ranged from 18 to 88 years of age. Outcomes included complications and procedure failure requiring repeat procedure in an operating theatre. Estimated cost savings were calculated according to staff wages and do not account for consumables. Estimated duration of minor procedure room operation was one hour per case. Results: Overall, 350 patients (285 male, 65 female) underwent local anaesthetic only procedures in the minor procedure room. The mean age of patients was 42. There were 309 hand/upper limb cases, 31 general plastic surgery cases, two skin cancer excisions and eight lower limb cases. There were no complications and no procedure failures. The average cost saved per procedure is estimated to be AU$486 with an average reduction of 44 theatre sessions per year. Conclusion: A minor procedure room for local anaesthetic only surgery can generate significant cost and time savings for a hospital when implemented and managed appropriately. This model has been successful in our institution and can likely be replicated in other centres.