Fast track surgery is a surgical technique that seeks to intensify the recovery process of patients after surgery. This approach, which is applied above all in the implantation of knee and hip prostheses, implies a comprehensive and multidisciplinary action to reduce hospitalization time and improve the quality of life after the operation.
The main goal of fast track surgery is to minimize the stress and trauma that occurs to the body during surgery. This is accomplished through minimally invasive surgical techniques, the use of regional anesthesia instead of general anesthesia, and postoperative pain control.
“Strictly speaking, more than a different surgery, it is a multidisciplinary hospital organizational protocol aimed at optimizing the recovery and post-surgical rehabilitation of the patient,” says Dr. Jordi Tomás Hernández, from the Traumatology and Orthopedic Surgery Service of the Quirónsalud Hospital Barcelona.
An approach that has shown a significant reduction in hospital stay, a lower rate of postoperative complications and faster recovery compared to traditional methods of surgery.
This protocol is applied to patients with a good state of health and few morbidities who must undergo scheduled knee or hip replacement surgery, which can cover 85% of patients with these ailments. It is a set of actions that are part of the traditional process of a surgical intervention of these characteristics, from early mobilization after surgery, adequate nutrition and patient education for a quick and effective recovery.
“Fast track surgery does not require any technical equipment other than that used for conventional surgeries. The differential point is the modification of the pre, intra and post surgical organizational protocol at different levels: nursing, anesthesia, surgery and rehabilitation-physiotherapy”, explains Dr. Tomás Hernández.
The key is to introduce small changes in this circuit. Thorough preoperative education for the patient, the use of multimodal analgesia during surgery with the use of peripheral blocks and local anesthesia, the use of tranexamic acid to minimize bleeding or exquisite surgery that minimizes tissue damage, make the patient recover earlier from the process.
Therefore, the key to the success of fast track surgery lies in the human team. It is necessary to dedicate to this protocol people trained in educating and accompanying the patient throughout the process. “It is essential that the patient is perfectly informed and motivated to comply with the protocol, that the objectives to be achieved each day in the postoperative period have been clearly explained to them and that they have real expectations of the process at all times,” adds the Hospital specialist. Quirónsalud Barcelona.
Some centers that already apply the fast track protocol effectively, such as the aforementioned case of Hospital Quirónsalud Barcelona, ​​have incorporated the figure of a nursing professional as a specific manager for these patients, who is in charge of explaining the entire process in detail and resolving the doubts of the patients at any time. Likewise, it is in charge of monitoring the telephone and providing support to the patient once they return home.
The hospital organization as a whole must also adjust to this protocol, for example by grouping these patients in a specific area of ​​the hospital with a stable nursing team well trained in cures and in their specific postoperative needs.
At the surgical level, a medical team with experience in this type of surgery is also required, which can minimize the operating time so as to minimize bleeding with the least aggressive surgery possible, which will help to avoid complications.
Finally, a good physiotherapy team is essential, well trained in the specific rehabilitation of these patients and with a physiotherapy protocol with clear objectives to follow daily after the intervention.
