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Shaw AV, Holmes DG, Jansen V, Fowler CL, Wormald JC, Wade RG, Reay EK, Gardiner MD. Adapting to the COVID-19 pandemic: A survey of UK and European hand surgery units. J Plast Reconstr Aesthet Surg 2022; 75:1682-1688. [PMID: 35000883 PMCID: PMC8600752 DOI: 10.1016/j.bjps.2021.11.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/10/2021] [Indexed: 01/31/2023]
Abstract
Hand surgery services had to rapidly adapt to the coronavirus disease 2019 (COVID-19) pandemic. The aim of the Reconstructive Surgery Trials Network #RSTNCOVID Hand Surgery survey was to document the changes made in the UK and Europe and consider which might persist. A survey developed by the Reconstructive Surgery Trials Network, in association with the British Association of Hand Therapists, was distributed to hand surgery units across the UK and Europe after the first wave of COVID-19. It was completed by one consultant hand surgeon at each of the 44 units that responded. Adult and paediatric trauma were maintained but elective services stopped. Consultations were increasingly virtual, and surgery was more likely to be under local anaesthetic and in a lower resource setting. Many of the changes are viewed as being beneficial. However, it is important to establish that they are clinically and cost effective. These survey results will help prioritise and support future research initiatives.
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Affiliation(s)
- Abigail V. Shaw
- Department of Plastic Surgery, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, UK,Corresponding author
| | - David G.W. Holmes
- Department of Orthopaedic Surgery, Leighton Hospital, Mid Cheshire Hospital NHS Foundation Trust, Middlewich Road, Crewe CW1 4QJ, UK
| | - Victoria Jansen
- Pulvertaft Hand Centre, University Hospitals of Derby and Burton NHS foundation Trust, Uttoxeter Road, Derby DE22 3NE, UK
| | - Christy L. Fowler
- Guy's and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK
| | - Justin C.R. Wormald
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science (NDORMS), University of Oxford, Windmill Road, Oxford OX3 7LD, UK
| | - Ryckie G. Wade
- Leeds Institute for Medical Research, University of Leeds, Leeds LS2 9JT, UK
| | - Emma K. Reay
- Department of Hand Surgery, James Cook University Hospital, South Tees NHS Foundation Trust, Marton Road, Middlesborough TS4 3BW, UK
| | - Matthew D. Gardiner
- Department of Plastic Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham Street, Slough SL2 4HL, UK,Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Roosevelt Drive, Oxford OX3 7FY, UK
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Covino M, Fulchignoni C, Pietramala S, Barbaliscia M, Franceschi F, Maccauro G, Merendi G, Rocchi L. One Year of COVID-19: Lessons Learned in a Hand Trauma Center. J Clin Med 2022; 11:jcm11082163. [PMID: 35456256 PMCID: PMC9024795 DOI: 10.3390/jcm11082163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 12/04/2022] Open
Abstract
2020 will be remembered worldwide as the year of COVID-19 outbreak. The onset of this pandemic abruptly changed everybody’s life and, in a particular manner, doctors’ lives. Our hand surgery department became rapidly one of the first COVID-19-specialized wards in Italy, impacting considerably the authors’ routines and activities. In this paper, the authors focus on how the demographics of patients with hand trauma changed and how they had to modify their activity. The authors retrospectively took into consideration all patients reaching their emergency department (ED) with hand trauma between 9 March 2020 (the day of the beginning of the first lockdown in Italy) and 8 March 2021 and compared them to those who reached the ED in the three previous years. Authors have analyzed the number of patients, their gender and age, the severity of their trauma, where the trauma occurred, the type of lesion, the percentage of patients who underwent surgery, and the percentage of patients who had an emergency admission. In the last year, the number of patients reaching the ED for a hand trauma has been reduced by two thirds (975 patients during the past year), the mean age of those patients has slightly increased, the severity of cases has increased, places of trauma and type of lesions have changed, and, lastly, the percentage of patients needing surgery who were admitted immediately has increased. This paper shows how the type of patients reaching the ED changed and discusses how surgeons evolved and modified their habits in treating those patients during the first lockdown and the year that followed.
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Affiliation(s)
- Marcello Covino
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (M.C.); (F.F.)
| | - Camillo Fulchignoni
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (S.P.); (M.B.); (G.M.); (L.R.)
- Correspondence: ; Tel.: +39-331-788-0630
| | - Silvia Pietramala
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (S.P.); (M.B.); (G.M.); (L.R.)
| | - Marco Barbaliscia
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (S.P.); (M.B.); (G.M.); (L.R.)
| | - Francesco Franceschi
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (M.C.); (F.F.)
| | - Giulio Maccauro
- Orthopedics & Traumatology Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy;
| | - Gianfranco Merendi
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (S.P.); (M.B.); (G.M.); (L.R.)
| | - Lorenzo Rocchi
- Orthopedics & Hand Surgery Unit, Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS—Catholic University of the Sacred Hearth, 00168 Rome, Italy; (S.P.); (M.B.); (G.M.); (L.R.)
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