The Patient’s Perspective: Burn Reconstructive Surgery During the COVID-19 Pandemic

Abstract

During the Covid-19 pandemic, hospital systems delayed or halted elective surgeries and outpatient care, profoundly disrupting reconstructive burn treatment ranging from surgery to postoperative therapy. This study aims to characterize burn patients’ perspectives on reconstructive surgery during Covid-19. A 12-component questionnaire to burn patients awaiting reconstructive surgery at a single ABA verified Burn Center was administered. Responses regarding willingness to undergo reconstruction, perceived medical and personal impacts of Covid-19, and perspectives on telehealth were gathered. Surveys were administered to patients/caregivers over the phone in English and Spanish. Inclusion criteria consisted of burn patients who had elective reconstructive surgeries delayed or canceled as a result of the pandemic. 51 patients met our inclusion criteria. Of those, 23 patients responded to our survey (45%). Average patient age was 23, 43% were male, and a majority (52%) were pediatric. 22 (96%) patients were willing to undergo reconstruction during the Covid-19 pandemic, despite a perceived increased risk. 43% disagreed or strongly disagreed that telehealth adequately enabled communication with their burn care provider. 78% agreed or strongly agreed that they felt more susceptible to Covid-19 as burn patients. 83% agreed or strongly agreed that the Covid-19 pandemic had created stressors specifically related to their burn care. The majority of patients expressed a strong desire to return to surgical and therapeutic care delayed by Covid-19. Patients reported feeling especially vulnerable to the Covid-19 pandemic as burn patients, and cited difficulty obtaining care and financial stressors as the main causes.

Pediatric Plastic Surgery in the COVID-19 Era

“…Despite this, 83% of respondents strongly preferred to resume surgical and therapeutic care delayed because of the pandemic. 69 Awareness and management of barriers to care continue to be a long-term challenge of the pandemic.…”

“…68 Aside from the medical outcomes, a survey study examined patient perspectives on burn reconstructive surgery during the pandemic. 69 Forty-three percent of respondents were pediatric. 69 It showed that the COVID-19 pandemic contributed to additional stressors in their burn treatment, including financial elements and difficulty attaining care.…”

“…69 Forty-three percent of respondents were pediatric. 69 It showed that the COVID-19 pandemic contributed to additional stressors in their burn treatment, including financial elements and difficulty attaining care. Despite this, 83% of respondents strongly preferred to resume surgical and therapeutic care delayed because of the pandemic.…”

“…It showed that the COVID-19 pandemic contributed to additional stressors in their burn treatment, including financial elements and difficulty attaining care. Despite this, 83% of respondents strongly preferred to resume surgical and therapeutic care delayed because of the pandemic 69 . Awareness and management of barriers to care continue to be a long-term challenge of the pandemic.…”

The Impact of COVID-19 on Reconstructive Surgery for Burns and Complex Wounds

“…Our group and others have previously demonstrated the impact on outpatient care, admissions and acute surgical resources, and described initiatives to replace in-person with virtual consultation whenever possible. 7,9,10 For vulnerable patient populations with suboptimal access to surgical care, the pandemic has resulted in exacerbation of pressure injuries, and delays in definitive care for NSTI, and care may have been provided in environments unfamiliar or ill-equipped to provide the kind of holistic management available at a multidisciplinary burn centre. 11–13 Reduced opportunities for trainees to participate in surgery for complex wounds and scars have also been evident, and may further entrench a system favouring sub-speciality over general plastic surgery practice.…”