key: cord-0078040-giimeqp5
authors: Rogers, Alan D.
title: The Impact of COVID-19 on Reconstructive Surgery for Burns and Complex Wounds
date: 2022-05-11
journal: Plast Surg (Oakv)
DOI: 10.1177/22925503221094104
sha: 77c4eac3aea058c31535960220c110cabff80bfc
doc_id: 78040
cord_uid: giimeqp5

nan

The mean number of acute burn surgeries per year during the pandemic was similar to the number per year preceding the pandemic (Table 1) ; the mean number of all cases performed per burn surgeon per year was 99 (range 79-128.5), down from 110.3 (range 76-155) ( Table 2 ). While the mean case duration was longer during the pandemic, the burn operating room occupancy was not significantly different from prior years ( Table 3) .

There was a significant reduction in the number of burn reconstructions undertaken during the pandemic when compared with the pre-pandemic period, with a mean of 31.5 cases performed per year, in comparison with a mean of 58.7 pre-pandemic; the deficit approximates the mean total number of burn reconstructions usually performed per year (n = 58) ( Table 1) .

Furthermore, there was a significant reduction in the number of complex wound cases during the period; the low number performed during 2021 (n = 25) was responsible for this difference. As was the case with burn reconstruction, the total number of cases "not performed" during the pandemic (n = 76), was similar to 1 year of these cases (n = 77.7) ( Table 1) .

The reduction in complex wound and burn reconstruction surgeries reflects policies to protect the specialist nursing workforce at the regional burn centre. Our group and others have previously demonstrated the impact on outpatient care, admissions and acute surgical resources, and described initiatives to replace in-person with virtual consultation whenever possible. 7, 9, 10 For vulnerable patient populations with suboptimal access to surgical care, the pandemic has resulted in exacerbation of pressure injuries, and delays in definitive care for NSTI, and care may have been provided in environments unfamiliar or ill-equipped to provide the kind of holistic management available at a multidisciplinary burn centre. [11] [12] [13] Reduced opportunities for trainees to participate in surgery for complex wounds and scars have also been evident, and may further entrench a system favouring sub-speciality over general plastic surgery practice.

In conclusion, this work highlights that while acute burn surgery has continued without significant impact at this regional burn centre, this may have been possible only at the expense of the delivery of care to other patient populations; it remains to be seen how this deficit can most effectively be addressed.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The author(s) received no financial support for the research, authorship, and/or publication of this article.

This was a QI initiative to determine the impact of COVID-19 so as to adapt appropriately. The author is the QI lead for the Ross Tilley Burn Centre.

Alan D. Rogers https://orcid.org/0000-0001-6821-1267 

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