Our data suggests that drain-free abdominal closure in DIEP reconstruction can be safely achieved without increased postoperative complications. These conclusions support existing evidence on the use of a drain-free approach in cosmetic abdominoplasty.
Mammalian bites are common injuries, but management has been shown to vary widely. The aim of this study was to assess how the COVID-19 pandemic impacted management of mammalian bite injuries and resulting outcomes.
We conducted a retrospective review of prospectively collected data on mammalian bite injuries assessed in our Plastic and Reconstructive Surgery department during April and May 2020.
37 patients presented with mammalian bite injuries during this period. Median age was 27 (range 1-75) with equal gender distribution. The majority presented on the day or day after injury. Bites were from dogs (78%), humans (14%) and cats (8%). Body parts involved were finger/hand (21), face (8), arm/forearm (5) and thigh/leg (3). 6 wounds were superficial (i.e. not penetrating the full-thickness of the skin) and 4 were associated with a fracture or significant soft tissue damage.
30 out of 31 non-superficial injuries were washed out under local anaesthesia, patients received a tetanus booster (if required) and were discharged with oral antibiotics and safety net advice. One wound associated with extensor tendon injury and metacarpal fracture was admitted and treated in the operating theatre. No complications were registered and only one patient represented with an infected wound, which was washed out under local anaesthesia and the patient discharged.
Our experience during the COVID-19 pandemic suggests that the majority of mammalian bite injuries can safely be managed with washout under local anaesthesia, oral antibiotics and discharge on the same day with safety net advice. Going forward, healthcare resources can be optimised by taking these results into account.
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