Changes in Burn Surgery Operative Volume and Metrics due to COVID-19.

Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases). Inclusion criteria were cases related to burns. Case types and operative metrics were compared amongst the three time-periods. Compared to the hospital, the burn service had a smaller decrease in volume during early COVID (28.7% vs 50.1%) and exceeded prepandemic volumes during late COVID (+21.8% vs -4.6%). There was a significant increase in excision and grafting cases in early and late COVID periods (P < .0001 and P < .002). There was a significant decrease in laser scar procedures that persisted even during late COVID (P < .0001). The projected and actual lengths of cases significantly increased and persisted into late COVID (P < .01). COVID-19 related operating room closures led to an expected decrease in the number of operative cases. However, there was no significant decline in the number of burn specific cases. The elective cases were largely replaced with excision and grafting cases and this shift has persisted even after elective cases have resumed. This change is also reflected in increased operative times.

Hidradenitis Suppurativa Reddit Support Group: Finding New Meaning in Social Media during the COVID-19 Pandemic

Introduction Hidradenitis suppurativa (HS) is a chronic inflammation of sweat glands that can result in abscesses and scarring, significantly impacting quality of life. Online support groups provide a platform to connect with other HS patients – increasingly important with pandemic-related social isolation. The popular social media site Reddit allows users with common interests, like HS, to form a community and share information. This study characterizes HS patients’ use of Reddit and social media more broadly before and during the COVID-19 pandemic. Methods This study consisted of a cross-sectional survey of HS patients treated at our institution between May 2021 and July 2021, collecting data on patient demographics, HS status, and social media support group usage/interest. A longitudinal analysis of use of a popular HS support page on Reddit from January 2019 to August 2021 was also conducted, analyzing the number of subscribers over time. Results The number of subscribers to the subreddit r/Hidradenitis increased exponentially from January 2019 to August 2021 (R2= 0.9978 for exponential model fit to data);this suggests that the onset of the COVID-19 pandemic was associated with a greater increase in the number of subreddit subscribers. Further, 20 patients (90% female, mean age of 32.4 years) completed the survey that was administered. Participants were stratified into two groups: online support group users (n=8) and non-users (n=12). There were no significant differences in sex, age, education level, HS activity, antidepressant usage, and overall social media usage between these groups. However, there was a significant difference in Hurley staging between the two groups;75% (n=6) of online support group users reported a Hurley III staging, while only 16.7% (n=2) of non-users self-reported as Hurley III (p=0.003). In terms of features patients desired to see in online support groups, non-users ranked the following categories of advice/information as important more frequently than current users: bandaging/dressing boils, living with HS, medical advice from professionals, causes of HS, and diet (p=0.047, p=0.043, p=0.043, p=0.047, and p=0.013, respectively). Conclusions This study demonstrates that online support group use is associated with patients with HS of higher clinical severity. Since virtual support groups have an unprecedented importance due to increased social isolation and limited access to in-person support groups and health resources, healthcare providers may encourage non-users to partake in these online support communities during these trying times. Based on the needs and expectations of these patients as identified in this study, recommendations can be made to moderators of online communities to help fill any existing lacunae.