The Impact of the COVID-19 Pandemic on Plastic Surgery Consultations in the Emergency Department

Abstract

Background: Stay-at-Home (SAH) orders implemented in the United States to combat COVID-19 had a significant impact on health care delivery for patients with all conditions. In this study, we examined the effect SAH orders had on the Emergency Department (ED) consultation volume, injury patterns, and treatment of patients managed by our plastic surgery service. Methods: In Rhode Island, SAH orders were instituted from March 28, 2020, to June 30, 2020. A retrospective chart review of patients presenting to our Level-1 academic medical center was performed. Patient demographics, types of injuries, and need for treatment in the ED or operating room (OR) were collected. Tests of significance were conducted using a comparison group spanning the same time period, in 2019. Results: There was a 36% decrease in ED consultations to plastic surgery during SAH orders when compared with those in 2019. No observed differences were noted in patient demographics between time periods. There were significant increases in the proportions of hand injuries secondary to power tools and facial injuries secondary to falls. No observed differences were identified in injury severity and need for either operating-room interventions or ED interventions for patients seen in consultation during SAH orders. Conclusions: SAH orders resulted in a decreased volume of plastic surgery consults in the ED but did not alter patient demographics, injury severity, or need for procedural interventions. There was a 2.9% positivity rate for COVID-19 for asymptomatic patients presenting in the ED with primary hand and facial injuries.

Strategic planning of plastic surgery emergencies during the COVID-19 pandemic: Lessons learnt from a tertiary plastic surgery centre

“…Emergency referrals to St. George's decreased from 1,070 in 2019 to 692 in 2020. This significant decrease of 35.3% (p<0.01) corresponds to data in other studies 1 , 2 . There was a similar gender distribution in both years.…”

The Evolution of Hand Injuries at a State’s Only Level I Trauma Center: A Look From the 1980s Through the Global Pandemic

“…Several studies examined hand trauma during the COVID-19 lockdown [ 8 - 14 ]. Garude et al found that there were more injuries from tools at home compared to the pre-COVID-19 cohort, which was also found by Ho et al, Paiva et al, Sugrue et al, and Fortane et al [ 8 - 10 , 12 - 13 ]. Ho et al also found that workplace and domestic violence injuries increased during the COVID-19 lockdown in Sydney, Australia [ 9 ].…”

Surgical Protocols before and after COVID-19—A Narrative Review

“…The investigators attributed this decrease in the riskiness of the surgical site because the pharynx and upper digestive tract are where sick people often have the highest virus loads [ 30 ]. On the other hand, a comparative study done in the US employing a similar methodological approach found fewer emergency cases were hospitalised after a cosmetic surgery than in 2019 [ 31 ].…”