Oral Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

The effects of COVID-19 in plastic surgery emergencies: What have we learned? (1367)

Robert Phan 1 , David Lee 1 , David Urbanavicius 1 , Thomas Boland 1 , Maryum Qureshi 1 , Richard Zinn 1 , Rodrigo Teixeira 1
  1. Plastic and Reconstructive Surgery, Northern Health, Epping, Victoria, Australia

Introduction: COVID-19 has had significant impact upon all health services. On 16th March 2020 the state of Victoria introduced policies to reduce the risk of COVID transmission, such as banning congregations. Clinicians were also compelled to alter their practice to reduce risk to health care workers and patients such as reducing aerosol generating anaesthesia. This study aimed to determine if these measures have changed the presentation patterns in traumatic injuries and anaesthesia use.

Method: A retrospective analysis of plastic surgery emergencies presenting to our health service from 15th January to 14th May in 2019 and 16th January to 14th May 2020 was performed, representing 60 days either side of lockdown measures.

Results: 307 patients presented prior to lockdown and 307 presented after in 2019, with 307 and 287 patients presenting in 2020 respectively. Patients presented with similar age distribution, location of injury and region of injury, although less patients were injured with power tools and more injured by crush injury in 2020. When comparing after lockdown in 2020 and corresponding period in 2019, there was an increase in power tool, crush and workplace related injuries, with corresponding decrease in sporting injuries. There was a reduction in proportion of general anaesthesia use after guidelines were revised with no adverse patient outcomes.

Conclusion: Although similar number of traumas cases requiring operative management presented in 2019 and 2020 periods either side of lockdown, the mechanism of injury, location and region of injury did show differing trends, which can be used for future risk education and resource allocation. Anaesthesia use was successfully de-escalated without adverse events, enhancing both patient and clinician safety and likely reflects previous overuse of general anaesthesia and sedation.