Arch Hand Microsurg.  2022 Mar;27(1):23-32. 10.12790/ahm.21.0120.

Impact on the service volume of a single hand surgery center during the COVID-19 pandemic period in Daegu

• Oh SH
• Kim YW
• Woo SH

• KMID: 2526645
• DOI: http://doi.org/10.12790/ahm.21.0120

Abstract

Purpose
We investigated what changes occurred at single hand surgery center during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, Korea using patient data of 4 years (2018–2021).
Methods
This is a single-center retrospective study of patients visiting our center during the COVID-19 pandemic (January 22 to May 6, 2020) in comparison to the most recent 4 years from 2018 to 2021. Service volumes (SVs) including the number of in/outpatients, emergency room, elective, and emergency surgeries were analyzed. The demographics, injury mechanism, and place of injury of hand trauma were analyzed in patients seen during the peak period of COVID-19 (February 24 to March 9, 2020) at W Hospital.
Results
SVs were significantly reduced in 2020 as compared with other years. The SVs except for the number of emergency surgeries have recovered after 2 months from the first confirmed case of COVID-19 in Daegu, Korea. At the peak period, the effect of COVID-19 was weak on emergency room-related SVs. In addition, a daily number of in/outpatients and elective surgeries had a statistically significant negative correlation with the number of COVID-19 confirmed (p<0.05). During the peak period, superficial laceration increased and finger and wrist fractures decreased. The number of cases occurring in workplace increased, however, occurring outside during daily life decreased.
Conclusion
COVID-19 pandemic greatly reduces service volume in our center. Thorough protective strategy from COVID-19 such as personal protective equipment was essential for early recovery of hospital functions during the pandemic. In addition, manpower for the emergency room must be preserved during the pandemic. The results of our study, which reported SVs through the pandemic will help maintain the function of hand surgery centers.

Keyword

Neoplasms; Malignant; Sweat glands; fingers

Figure

• 

  Fig. 1. Changes in the number of coronavirus disease 2019 (COVID-19) confirmed cases by week from January 22 to May 6 in 2020.

• 

  Fig. 2. Changes in the number of outpatients by week from January 22 to May 6 for 4 years (2018–2021). COVID-19, coronavirus disease 2019.

• 

  Fig. 3. Changes in the number of inpatients by week from January 22 to May 6 for 4 years (2018–2021). COVID-19, coronavirus disease 2019.

• 

  Fig. 4. Changes in the number of emergency room patients by week from January 22 to May 6 for 4 years (2018–2021). COVID-19, coronavirus disease 2019.

• 

  Fig. 5. Changes in the number of elective surgeries by week from January 22 to May 6 for 4 years (2018–2021). COVID-19, coronavirus disease 2019.

• 

  Fig. 6. Changes in the number of emergency surgeries by week from January 22 to May 6 for 4 years (2018–2021). COVID-19, coronavirus disease 2019.

• 

  Fig. 7. Comparison of the service volumes (outpatient, inpatient, emergency room patients, elective surgeries, and emergency surgeries) during 3 years (average of service volumes in 2018, 2019, and 2021) and the peak period.

• 

  Fig. 8. Correlation of the number of outpatients, inpatients, and elective surgeries with the number of coronavirus disease 2019 (COVID-19) confirmed patients by week from January 22 to May 6, 2020. The number of patients showed a negative correlation with the number of COVID-19 confirmed patients.

• 

  Fig. 9. Correlation of the number of outpatients, inpatients, and elective surgeries with the number of coronavirus disease 2019 (COVID-19) confirmed patients in 2020 (simple regression test).

• 

  Fig. 10. A hand surgeon and other members of the surgical team wearing personal protective equipment (protective level-D gown, boots, face shield, and N95 mask) and performing replantation before confirmation of a negative result from a coronavirus disease 2019 polymerase chain reaction test.

Reference

References

1. Central Disaster Management Headquarters; Ministry of Health and Welfare (MOHW). Coronavirus disease-19, Republic of Korea [Internet]. Seoul: MOHW;c2021. [cited 2021 Jul 15]. Available from: http://ncov.mohw.go.kr/.

2. Rodrigues-Pinto R, Sousa R, Oliveira A. Preparing to perform trauma and orthopaedic surgery on patients with COVID-19. J Bone Joint Surg Am. 2020; 102:946–50.

3. Omar UF, Pei Yein T, Rajaratnam V. Managing hand and reconstructive microsurgery service during COVID-19 pandemic: Singapore experience. Postgrad Med J. 2020; 96:379–83.

4. Atia F, Pocnetz S, Selby A, Russell P, Bainbridge C, Johnson N. The effect of the COVID-19 lockdown on hand trauma surgery utilization. Bone Jt Open. 2020; 1:639–43.

5. Ho E, Riordan E, Nicklin S. Hand injuries during COVID-19: lessons from lockdown. J Plast Reconstr Aesthet Surg. 2021; 74:1408–12.

6. Chang Liang Z, Wang W, Murphy D, Po Hui JH. Novel coronavirus and orthopaedic surgery: early experiences from Singapore. J Bone Joint Surg Am. 2020; 102:745–9.

7. Poggetti A, Del Chiaro A, Nucci AM, Suardi C, Pfanner S. How hand and wrist trauma has changed during COVID-19 emergency in Italy: incidence and distribution of acute injuries. What to learn? J Clin Orthop Trauma. 2021; 12:22–6.

8. Woo SH. How the “W Hospital,” Daegu, Korea, manages to combat COVID-19. IFSSH Ezine. 2020; 10:42–6.

9. W Hospital. Annual report in hand & microsurgery orthopedic surgery of W Hospital, Republic of Korea [Internet]. Daegu: W Hospital;c2021. [cited 2021 Jul 30]. Available from: http://w-hospital.co.kr/front/board/list_php?code=surgery.

10. Daegu Metropolitan City. Coronavirus-19 bulletin board [Internet]. Daegu: Daegu Metropolitan City;c2021. [cited 2021 Jul 15]. Available from: http://covid19.daegu.go.kr/index.html.

11. Welman T, Hobday D, El-Ali K, Pahal GS. The COVID-19 pandemic: the effect on hand trauma in Europe’s busiest major trauma centre. J Plast Reconstr Aesthet Surg. 2021; 74:644–710.

12. Arianni M, Arnaout A, Castro-Obeso J, et al. Variety of hand surgery cases during the COVID-19 pandemic: experiences from seven countries. J Musculoskelet Surg Res. 2021; 5:15.

13. Garude K, Natalwala I, Hughes B, West C, Bhat W. Patterns of adult and paediatric hand trauma during the COVID-19 lockdown. J Plast Reconstr Aesthet Surg. 2020; 73:1575–92.

14. Farid Y, Schettino M, Kapila AK, et al. Decrease in surgical activity in the COVID-19 pandemic: an economic crisis. Br J Surg. 2020; 107:e300.

15. Martin-Playa P, Calzacorta-Muñoz P, Aparicio Elizalde L, Carrera-Casal O, García Gutiérrez JJ. An overview of the situation of hand surgery in Spain during the peak of COVID-19 pandemic. Hand Surg Rehabil. 2020; 39:454–8.

16. Facchin F, Messana F, Sonda R, Faccio D, Tiengo C, Bassetto F. COVID-19: initial experience of hand surgeons in Northern Italy. Hand Surg Rehabil. 2020; 39:332–3.

17. Ozturk CN, Kuruoglu D, Ozturk C, Rampazzo A, Gurunian Gurunluoglu R. Plastic surgery and the COVID-19 pandemic: a review of clinical guidelines. Ann Plast Surg. 2020; 85(2S Suppl 2):S155–60.

18. Saleh S, Faulkner H, Golledge K, et al. The impact of COVID-19 on hand trauma. Hand (N Y). 2021; Jul. 26. [Epub]. https://doi.org/10.1177/15589447211028918.