Nationwide analysis of plastic and reconstructive procedural volume in the United States during the COVID-19 pandemic

Mehrabian, Daniel; Liu, Ivan; Pakhchanian, Haig; Tarawneh, Omar; Raiker, Rahul; Boyd, Carter J.

doi:10.1016/j.bjps.2021.11.100

Cited by 8 publications

(7 citation statements)

References 19 publications

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“…However, this initial report is important for informing providers and patients to equip them with this information for addressing subsequent surges in COVID-19 cases across the country and world. 12 …”

Section: Discussionmentioning

confidence: 99%

Breast reconstruction during the COVID-19 pandemic: Single institution experience from the pandemic's epicenter in the United States

Boyd

Hemal

Ramesh

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Discussionmentioning

confidence: 99%

Breast reconstruction during the COVID-19 pandemic: Single institution experience from the pandemic's epicenter in the United States

Boyd

Hemal

Ramesh

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…The COVID-19 pandemic has profoundly impacted health care practices across the world, including the delivery of reconstructive surgery. [11][12][13][14][15][16] In this retrospective review of COVID-19 incidence among patients undergoing flap reconstruction at a high-volume institution during the early pandemic, we found five cases of community-acquired and no cases of hospital-acquired COVID-19. Additionally, there were no significant differences in 30-day readmissions, medical outcomes, or surgical outcomes (including flap takebacks) between patients who underwent free flap reconstructive surgery before and during the early pandemic.…”

Section: Discussionmentioning

confidence: 99%

Reintroducing Flap Reconstruction: One Institution's Safe Return to Flap Surgery during the COVID-19 Pandemic

Chen

Chow

Lee

et al. 2022

J Reconstr Microsurg

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Background Prevention of nosocomial coronavirus disease 2019 (COVID-19) infection for patients undergoing flap-based reconstructive surgery is crucial to providing care and maintaining operative volume and income to support plastic surgery programs. We conducted this study to (1) determine the postoperative incidence of COVID-19 among patients undergoing flap reconstruction from December 1, 2019 to November 1, 2020 and (2) compare 30-day outcomes between patients who underwent surgery before and during the early pandemic. Methods We conducted an 11-month retrospective cohort study of all patients who underwent flap reconstruction across our institution. We abstracted patient demographics, intraoperative management, COVID-19 testing history, and 30-day postoperative complications from electronic health records. Nosocomial COVID-19 infection was defined as reverse transcription polymerase chain reaction (RT-PCR) viral ribonucleic acid detection within 30 days of patients' postoperative course or during initial surgical admission. We used chi-squared tests to compare postoperative outcomes between patients who underwent surgery before (prior to March 12, 2021, when our institution admitted its first COVID-19 patient) versus during (on/after March 12, 2021) the pandemic. Results Among the 220 patients (mean [standard deviation] age = 53.8 [18.1] years; female = 54.8%) who underwent flap reconstruction, none had nosocomial COVID-19 infection. Five (2%) patients eventually tested COVID-19 positive (median time from surgery to diagnosis: 9 months, range: 1.5–11 months) with one developing partial flap loss while infected. Between patients who underwent free flap surgery before and during the pandemic, there were no significant differences in 30-day takebacks (15.6% vs. 16.6%, respectively; p > 0.999), readmissions (9.4% vs. 12.6%, respectively; p = 0.53), and surgical complications (e.g., total flap loss 1.6% vs. 2.1%, p = 0.81). Conclusion Robust precautions can ensure the safety of patients undergoing flap surgeries across an academic medical institution, even during periods of high COVID-19 admission rates. Further studies are needed to generate evidence-based guidelines that optimize infection control and flap survival for patients undergoing reconstruction.

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“…As no secondary procedures were performed to enhance cosmetic outcomes, we believe that our tailored approach to partial defects of the ear was successful in addressing common issues in auricle reconstruction. The selection of a single stage procedure was enthusiastically accepted by the elderly patients and, in our opinion, represents a valuable solution, especially during the COVID-19 pandemic, as it reduces patient access to hospitals [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study on Single-Stage Reconstruction of the Ear following Skin Cancer Excision in Elderly Patients

Bolletta

Losco

Pozzi

et al. 2022

JCM

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Ear reconstructive surgery aims to solve the deformities caused by cancer excision. Despite the numerous surgical procedures described, recreating the complex anatomy of the ear still represents a challenge, particularly for young surgeons. The purpose of this exploratory pilot study is to review our experience with single stage reconstruction of the partial defects of the auricle, and propose an algorithm based on defect size, location, and characteristics. We retrospectively reviewed patients who underwent ear reconstruction after cancer excision at our institution between February 2018 and November 2020. The data collected included patients’ demographics, defect characteristics, reconstructive technique used, complications, and outcomes. The patients were evaluated at a minimum follow-up time of 12 months. Forty-six patients were included in the study. The most common cause for ear reconstruction was basal cell carcinoma. The mean area of defect was 4.3 cm2 and the helix was the most frequent location of defect. Two patients experienced post-operative complications. At the one-year follow-up, difference in skin pigmentation was reported in 10 cases, a depressed contour of the ear was found in 4 cases, and moderate ear asymmetry was found in 11 cases. No patient needed a secondary procedure. In conclusion, the proposed reconstructive algorithm represents a reconstructive indication that is simple and characterized by low complication rates and good outcomes for both the patient and the surgeon.

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Nationwide analysis of plastic and reconstructive procedural volume in the United States during the COVID-19 pandemic

Cited by 8 publications

References 19 publications

Breast reconstruction during the COVID-19 pandemic: Single institution experience from the pandemic's epicenter in the United States

Breast reconstruction during the COVID-19 pandemic: Single institution experience from the pandemic's epicenter in the United States

Reintroducing Flap Reconstruction: One Institution's Safe Return to Flap Surgery during the COVID-19 Pandemic

A Retrospective Study on Single-Stage Reconstruction of the Ear following Skin Cancer Excision in Elderly Patients

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