St Andrew's COVID-19 surgery safety (StACS) study: Elective plastic surgery, trauma & burns. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Miranda, B.H.; Hughes, W.R.M.; Pinto-Lopes, R.; Mathur, B.S.; Ramakrishnan, V.V.; Sood, M.K.; Ahmad, Fateh; Banwell, Miles E; Barnes, David E; El-Muttardi, Naguib; Griffiths, Matthew; Hussain, Amer; Iwuagwu, Fortune C; Kangesu, Loshan; Khan, Waseem; Martin, Niall; Mopuri, Nabil; Morgan, Mary; Morris, Paul; Rorison, Patricia; Shelley, Odhran; Sierakowski, Adam; Tare, Makarand; Tzafetta, Kallirroi; Zweifel, Claire J; Appukuttan, Aswin; Balgaumwala, Tasneem; Counter, Oliver; Deelip Dhake, Swapnil; Fernandez-Diaz, Oscar F; Gathura, Esther; Harris, Nicola; Constantin Ion Jica, Romulus; Katechia, Devvrat; Lavender, Scott; Martin, David G; Mertic, Alex; Miranda, Adela; Myers, Jo; Nasrallah, Fady; Pantelides, Nicholas; Prior, Sheila; Raveendran, Sreekanth; Sell, Tracey; Sinha, Reetu; Smeeton, Ben T; Smith, Alex C D; Sofos, Stratos; Strong, Ben; Tang, Jasmine Y M; Thacoor, Amitabh; Tucker, Anne; Turkentine, Michele; Cornforth, Mark; Cowdery, Sally; Marasca, Alessandro; Palmer, Helen; Watts, Carole; Watts, Jan; Wiltshire, Rachel; Sing, Quillan Young; Zberea, Diana E; Mabvuure, Nigel T;
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 74:Issue 1(2021)
• Page Start: 211
• Page End: 222
• Publication Date: 2021-01
• Subjects: Coronavirus -- Surgery -- Plastic -- Trauma -- Burns -- Injuries -- General surgery; Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2020.08.039
• Languages: English
• ISSNs: 1748-6815

Abstract

Summary: Introduction: This study evaluates COVID-19 related patient risk, when undergoing management within one of the largest specialist centres in Europe, which rapidly implemented national COVID-19 safety guidelines. Method: A prospective cohort study was undertaken in all patients who underwent surgical ( n = 1429) or non-operative ( n = 191) management during the UK COVID-19 pandemic peak (April–May 2020); all were evaluated for 30-day COVID-19 related death. A representative sample of elective/trauma/burns patients (surgery group, n = 729) were selected and also sub-analysed within a controlled cohort study design. Comparison was made to a random selection of non-operatively managed (non-operative group, n = 100) or waiting list (control group, n = 250) patients. These groups were prospectively followed-up and telephoned from the end of June (control group) or at 30 days post-first assessment (non-operative group)/post-operatively (surgery group). Results: Complex general (9.2%, 136/1483) or regional (5.0%, 74/1483) anaesthesia cases represented 14.2% (210/1483) of operations undertaken. There were no 30-day post-operative (0/1429)/first assessment (0/191) COVID-19 related deaths. Neither the three sub-speciality plastic surgery, or non-operative groups, displayed increases in post-operative/first assessment symptoms in comparison to each other, or to control. The proportion of COVID-19 positive tests were: 7.1% (1/14) (non-operative), 5.9% (2/34) (burns) and 3.0% (3/99) (trauma); there were however no significant differences between these groups, the elective (0%, 0/54) and control (0%, 0/24) groups ( p = 0.236). Conclusion: We demonstrate that even heterogeneous sub-speciality patient groups, who required operative/non-operative management, did not incur an increased COVID-19 risk compared to each other or to control. These highly encouraging results were achieved with described, rapidly implemented service changes that were tailored to protect each patient group and staff.