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Safety of major reconstructive surgery during the peak of the COVID-19 pandemic in the United Kingdom and Ireland - multicentre national cohort study.
- Source :
-
Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2021 Jun; Vol. 74 (6), pp. 1161-1172. Date of Electronic Publication: 2020 Dec 13. - Publication Year :
- 2021
-
Abstract
- Background: The safety of surgery during and after the coronavirus disease-2019 (COVID-19) pandemic is paramount. Early reports of excessive perioperative mortality in COVID-positive patients promoted the widespread avoidance of operations. However, cancelling or delaying operations for cancer, trauma, or functional restitution has resulted in increased morbidity and mortality.<br />Methods: A national multicentre cohort study of all major reconstructive operations carried out over a 12-week period of the 'COVID-19 surge' in the United Kingdom and Ireland was performed. Primary outcome was 30-day mortality and secondary outcome measures were major complications (Clavien-Dindo grade ≥3) and COVID-19 status of patients and healthcare professionals before and after surgery.<br />Results: A total of 418 patients underwent major reconstructive surgery with a mean operating time of 7.5 hours and 12 days' inpatient stay. Cancer (59.8%) and trauma (29.4%) were the most common indications. COVID-19 infection was present in 4.5% of patients. The 30-day post-operative mortality was 0.2%, reflecting the death of one patient who was COVID-negative. Overall complication rate was 20.8%. COVID status did not correlate with major or minor complications. Eight healthcare professionals developed post-operative COVID-19 infection, seven of which occurred within the first three weeks.<br />Conclusions: Major reconstructive operations performed during the COVID-19 crisis have been mostly urgent cases involving all surgical specialties. This cohort is a surrogate for all major operations across all surgical specialties. Patient safety and surgical outcomes have been the same as in the pre-COVID era. With adequate precautions, major reconstructive surgery is safe for patients and staff. This study helps counsel patients of COVID-19 risks in the perioperative period.<br /> (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
COVID-19 transmission
Hospital Mortality
Humans
Infectious Disease Transmission, Patient-to-Professional
Ireland epidemiology
Middle Aged
Neoplasms surgery
Personnel, Hospital
Plastic Surgery Procedures statistics & numerical data
Retrospective Studies
SARS-CoV-2
United Kingdom epidemiology
Wounds and Injuries surgery
COVID-19 epidemiology
Pandemics
Postoperative Complications
Plastic Surgery Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1878-0539
- Volume :
- 74
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of plastic, reconstructive & aesthetic surgery : JPRAS
- Publication Type :
- Academic Journal
- Accession number :
- 33402316
- Full Text :
- https://doi.org/10.1016/j.bjps.2020.12.032