Optimising hand surgery during COVID-19 pandemic
Retrospective observational study published in J Hand Surg Asian Pac Vol (2021)
Abstract
Background: With the emergence of the COVID-19 pandemic, most health-care personnel and resources are redirected to prioritize care for seriously-ill COVID patients. This situation may poorly impact our capacity to care for critically injured patients. We need to devise a strategy to provide rational and essential care to hand trauma victims whilst the access to theatres and anaesthetic support is limited. Our center is a level 1 trauma center, where the pandemic preparedness required reorganization of the trauma services. We aim to summarise the clinical profile and management of these patients and highlight, how we modified our practice to optimize their care. Methods: This is a single-centre retrospective observational study of all patients with hand injuries visiting the Department of Plastic Surgery from 22nd March to 31st May 2020. Patient characteristics, management details, and outcomes were analysed. Results: A total of 102 hand injuries were encountered. Five patients were COVID-19 positive. The mean age was 28.9 ± 14.8 years and eighty-two (80.4%) were males. Thirty-one injuries involved fractures/dislocations, of which 23 (74.2%) were managed non-operatively. Seventy-five (73.5%) patients underwent wound wash or procedure under local anaesthetic and were discharged as soon as they were comfortable. Seventeen cases performed under brachial-plexus block, were discharged within 24 hours except four cases of finger replantation/ revascularisation and one flap cover which were discharged after monitoring for four days. At mean follow-up of 54.4 ± 21.8 days, the rates of early complication and loss to follow-up were 6.9% and 12.7% respectively. Conclusions: Essential trauma care needs to continue keeping in mind, rational use of resources while ensuring safety of the patients and health-care professionals. We need to be flexible and dynamic in our approach, by utilising teleconsultation, non-operative management, and regional anaesthesia wherever feasible.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Retrospective observational study of 102 hand injuries during COVID-19 pandemic at a level-1 trauma center, including finger replantation/revascularization cases.
Warum dies für die Hirudotherapie relevant ist
This single-center retrospective observational study describes management modifications for 102 hand injury patients during the COVID-19 pandemic, focusing on practice adaptations such as increased use of local/regional anesthesia, non-operative management, and teleconsultation. The study makes no mention of leech therapy, hirudotherapy, or venous congestion management in any context. There is no defensible leech-related relevance to ASH's domain in this article. The study addresses healthcare delivery logistics during a pandemic rather than any therapeutic modality related to the leech secretome or hirudotherapy.
Zitation
Optimising hand surgery during COVID-19 pandemic.
Saha S et al. · The journal of hand surgery Asian-Pacific volume, 2021
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