Evolutionary analysis of patient’s morbidity and mortality in emergency surgical care during the pandemic: Retrospective comparison between first and second waves of COVID-19

Recuenco, Carlos Bustamante; Pecharromán, Esther María Cano; Esparrell, Gloria María Mendoza; Ramos, Mahur Esmaillii; Benítez, Javier Broekhuizen; Paniagua, Leticia Martín; Duque, A. Teresa Calderón; Marín, Tomás Balsa

doi:10.1016/j.cireng.2022.10.007

Cited by 1 publication

(1 citation statement)

References 27 publications

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“…The pandemic evolved over time: different virus variants became endemic, and vaccinations became available. this moment there is no evidence suggesting differences in surgical outcomes depending on the virus variant or pandemic phase [21,22]. Contrarily, vaccination does contribute positively.…”

Section: Complicationsmentioning

confidence: 99%

COVID-associated complications after reconstructive breast surgery – a retrospective cohort study

Bubberman,

Claessen,

Feijen

et al. 2023

Preprint

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Purpose. The COVID pandemic significantly influenced reconstructive breast surgery regimens. Many surgeries were cancelled or postponed. COVID entails not only respiratory, but also coagulative symptoms. It therefore potentially increases the risk of postoperative complications. The incidence of perioperative COVID infection and its influence on postoperative recovery after reconstructive breast surgery is still unknown.Methods. This dual center retrospective cohort study included patients that underwent reconstructive breast surgery between March 2020 and July 2021. Post-mastectomy autologous or implant-based breast reconstruction (ABR; IBR), as well as post-lumpectomy oncoplastic partial breast reconstruction (PBR) were eligible. Patient data was extracted from electronic medical records. Data regarding COVID-19 infection was collected through a questionnaire. The primary outcome was complication rate.Results. The ABR, IBR and PBR groups consisted of 113 (12 COVID-positive), 41 (2 COVID-positive) and 113 (10 COVID-positive) patients. In the ABR and PBR groups, postoperative complications occurred significantly more often in patients with perioperative COVID-infection. Especially impaired wound healing occurred significantly more often in the ABR and PBR breasts, but also at the donor site of ABR patients with perioperative COVID.Conclusion. Perioperative COVID-infection increases susceptibility to complicated wound healing after reconstructive breast surgery. A possible explanation lies in the dysregulation of haemostasis by the virus, and its direct effects on microvasculature. A hypercoagulable state results. We recommend to postpone elective breast surgery for 4–6 weeks after COVID-19 infection. Also, precautionary measures remain important to minimize the risk of perioperative COVID-19 infection.

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Section: Complicationsmentioning

confidence: 99%