St Andrew’s COVID-19 surgery safety (StACS) study: The Burns Centre experience

Smith, Alex; Miranda, Benjamin H.; Strong, Ben; Jica, R.C.I.; Pinto-Lopes, Rui; Martin, Niall; El-Muttardi, Naguib; Barnes, David; Shelley, Odhran

doi:10.1016/j.burns.2021.01.006

Cited by 7 publications

(24 citation statements)

References 30 publications

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“…The respective studies originated in Graz, Austria [ 6 ]; Chongqing, China [ 7 ]; Chelmsford, UK [ 8 ]; Rabat, Morocco [ 9 ]; Barcelona, Spain; Singapore, Singapore; Torino, Italy; Iowa City and Seattle, USA; Chongqing and Shanghai, China; Birmingham, UK; Tokyo, Japan [ 10 ]; Petah Tikva, Israel [ 11 ]; Shanghai, China [ 12 ]; Johannesburg, Cape Town, Kimberley, and Durban, South Africa [ 13 ]; and Delhi, India [ 14 , 15 ]. A brief overview of the included studies and their key points is mentioned in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…As the number of infections increased, additional space was located at the burn ICU of the Harborview Medical Center in Seattle, while the Vall d’Hebron University Hospital in Barcelona fully transformed its burn unit into a non-COVID-19 ICU [ 10 ]. In some countries, burn care during the COVID-19 outbreak was centralized in dedicated hospitals [ 8 , 10 , 15 ]. The university hospital in Birmingham, for example, was designated as a National Burn Centre.…”

Section: Resultsmentioning

confidence: 99%

“…The most important step in reducing the infection rate and preventing a collapse of the health care systems is the provision of sufficient personal protective equipment (PPE), consisting of masks, preferably FFP2/3 or N95, gloves, protective goggles, and gowns [ 6 , 7 , 8 , 10 , 11 , 12 , 13 , 14 , 15 ]. In the burn unit of the University Hospital Graz in Austria, PPE was provided and distributed by the hospital management team [ 6 ].…”

Section: Resultsmentioning

confidence: 99%

“…For instance, these could comprise of the setup of triage units and isolation areas, the performance of emergency-only surgeries and the postponement of elective ones. These means should help to prevent the spread of SARS-CoV-2 and comply with burn care, as well as establish and maintain capacities for COVID-19 patients [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The aim of this review is to systematically map and summarize the experiences of various burn centers worldwide during the COVID-19 pandemic, along the range of strategies adopted during this time, as well as to identify any existing gaps in knowledge.…”

Section: Introductionmentioning

confidence: 99%

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Challenges in Burn Care during the COVID-19 Pandemic—A Scoping Review

Kohlhauser

Luze

Nischwitz

et al. 2022

JCM

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Objective: The aim of this review is to map and summarize the experiences of various burn centers worldwide during the COVID-19 pandemic, in order to enable future strategies with regard to the most effective measures in burn care during pandemics and to detect possible gaps in knowledge. Background: The coronavirus disease 2019 (COVID-19) pandemic had a major impact on economies, social interactions, and health systems worldwide. Burn units all over the world face a new challenge in maintaining the care of acute burn wounds and follow-up treatments while dealing with constantly changing regulations. Infrastructural changes, the establishment of efficient triage systems, protective measures, personnel resources, in addition to the maintenance of efficient patient care and the guarantee of supply chains, are challenging tasks to be addressed. This review provides an overview of recent developments regarding different strategies and methods used by burn units worldwide to safely overcome the COVID-19 pandemic outbreak. Methods: A scoping review of the literature was conducted using the electronic databases PubMed and Google Scholar. Publications were screened for the following key terms: burns, burn injuries, thermal injuries, burn center, burn unit, burn ward, in combination with COVID-19, COVID-19 pandemic, SARS-CoV-2, Corona, and Coronavirus. Articles dealing with the management of burn units during the pandemic were further analyzed and included. Results: Of the 136 publications, 10 were considered relevant to the key question and were included in the present review. Results were divided into six major topics, such as infrastructural and personnel management, triaging, severe burns and emergencies, elective surgeries, patient and visitor management, and outpatient management. Conclusion: Only a few studies about managing burn units during the COVID-19 pandemic have been published. Personnel resources and equipment needed to be redistributed to cope with country-specific challenges during the COVID-19 pandemic and to maintain adequate burn care. Since all of these articles refer to the period of the initial outbreak, a lack of clinical studies exists regarding the prevention measures taken by burn units during the COVID-19 pandemic. In addition, we identified gaps in knowledge about the impact of implemented measures on burn patient outcomes in the published literature. Further studies are mandatory in order to provide generally applicable guidelines regarding COVID-19 prevention measures at a burn unit.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Challenges in Burn Care during the COVID-19 Pandemic—A Scoping Review

Kohlhauser

Luze

Nischwitz

et al. 2022

JCM

View full text Add to dashboard Cite

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“…In patients with active COVID-19 infections undergoing surgery, there is a reported increase in surgical mortality and complications, 13 specifically increased pulmonary complications 14 and venous thromboembolism. 15,16 However, current data remains mixed with some showing no change in the rate of post-operative morbidity and mortality 17,18 In one large international multicenter cohort of 1128 patients undergoing surgery at 235 hospitals in 24 countries from January 1 to March 21, 2020, the COVID-19 infection rate was 26.1% preoperatively, with 51.2% suffering post-operative pulmonary complications and over-all 30-day mortality at 23.8%. 14 In another multicenter international prospective cohort study of 140,231 surgical patients from 116 countries, 2.2% had a pre-operative COVID-19 positive test and the adjusted odds ratio for 30-day mortality was significantly higher in patients having surgery within 7 weeks of a COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes in Benign Gynecologic Surgery Patients during the COVID-19 Pandemic (SOCOVID study)

Kho

Chang

Hare

et al. 2022

Journal of Minimally Invasive Gynecology

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Study Objective To determine the incidence of perioperative COVID-19 in women undergoing benign gynecologic surgery, and to evaluate perioperative complication rates in patients with active, prior or no prior SARS-CoV-2 infection. Design Multicenter prospective cohort study Setting Ten institutions in the United States Patients Patients over the age of 18 years who underwent benign gynecologic surgery from July 1, 2020 to December 31, 2020 were included. All patients were followed from the time of surgery until 10 weeks post-operatively. Those with intra-uterine pregnancy or known gynecologic malignancy were excluded. Interventions Benign gynecologic surgery Measurements The primary outcome was the incidence of perioperative COVID-19 infections which was stratified as 1) prior COVID-19 infection, 2) pre-operative COVID-19 infection and 3) post-operative COVID-19 infection. Secondary outcomes included adverse events and mortality following surgery, as well as predictors for post-operative COVID-19 infection. If surgery was delayed due to the COVID-19 pandemic, the reason for postponement and any subsequent adverse event was recorded. Main Results Of 3423 patients included for final analysis, 189 (5.5%) postponed their gynecologic surgery during the pandemic. Forty-three patients (1.3% of total cases) were due to a history of COVID-19. The majority (182 [96.3%]) had no sequelae attributed to surgical postponement. Following hospital discharge to 10 weeks post-operatively, 39 (1.1%) patients became infected with SARS-CoV-2. The mean duration of time between hospital discharge and the follow-up positive COVID-19 test was 22.1 ± 12.3 days (range 4-50 days). Eleven (31.4% of post-operative COVID-19 infections, 0.3% of total cases) of the newly diagnosed COVID-19 infections occurred within 14 days of hospital discharge. On multivariable logistic regression, living in the Southwest (adjOR 6.8) and single-unit increase in age-adjusted Charlson co-morbidity index (adjOR 1.2) increased the odds of post-operative COVID-19 infection. Peri-operative complications were not significantly higher in patients with a history of prior positive COVID-19 compared to those without a history of COVID-19, though the mean duration of time between prior COVID-19 diagnosis and surgery was 97 days (14 weeks). Conclusion In this large multi-center prospective cohort study of benign gynecologic surgeries, only 1.1% of patients developed a post-operative COVID-19 infection, with 0.3% of infection in the immediate 14-days after surgery. The incidence of post-operative complications was not different in those with and without prior COVID-19 infections.

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