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1.
Plast Reconstr Surg ; 148(4): 899-906, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1398200

ABSTRACT

SUMMARY: In the wake of the death toll resulting from coronavirus disease of 2019 (COVID-19), in addition to the economic turmoil and strain on our health care systems, plastic surgeons are taking a hard look at their role in crisis preparedness and how they can contribute to crisis response policies in their own health care teams. Leaders in the specialty are charged with developing new clinical policies, identifying weaknesses in crisis preparation, and ensuring survival of private practices that face untenable financial challenges. It is critical that plastic surgery builds on the lessons learned over the past tumultuous year to emerge stronger and more prepared for subsequent waves of COVID-19. In addition, this global health crisis presents a timely opportunity to reexamine how plastic surgeons can display effective leadership during times of uncertainty and stress. Some may choose to emulate the traits and policies of leaders who are navigating the COVID-19 crisis effectively. Specifically, the national leaders who offer empathy, transparent communication, and decisive action have maintained high public approval throughout the COVID-19 crisis, while aggressively controlling viral spread. Crises are an inevitable aspect of modern society and medicine. Plastic surgeons can learn from this pandemic to better prepare for future turmoil.


Subject(s)
COVID-19/prevention & control , Leadership , Professional Role , Surgery, Plastic/organization & administration , COVID-19/economics , COVID-19/epidemiology , COVID-19/transmission , Communicable Disease Control/standards , Global Health , Humans , Pandemics/economics , Pandemics/prevention & control , Patient Care Team/economics , Patient Care Team/organization & administration , SARS-CoV-2/pathogenicity , Surgeons/organization & administration , Surgery, Plastic/economics , Uncertainty
3.
Plast Reconstr Surg ; 148(3): 462e-474e, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1371774

ABSTRACT

BACKGROUND: The coronavirus disease of 2019 (COVID-19) pandemic has had a profound effect on surgical training programs, reflecting decreases in elective surgical cases and emergency restructuring of clinical teams. The effect of these measures on U.S. plastic surgery resident education and wellness has not been characterized. METHODS: An institutional review board-exempted anonymous survey was developed through expert panel discussion and pilot testing. All current U.S. plastic surgery trainees were invited to complete a cross-sectional 28-question survey in April of 2020. Respondents were queried regarding demographic information, educational experiences, and wellness during the COVID-19 pandemic. RESULTS: A total of 668 residents responded to the survey, corresponding to a 56.1 percent response rate. Sex, training program type, postgraduate year, and region were well represented within the sample. Nearly all trainees (97.1 percent) reported restructuring of their clinical teams. One-sixth of respondents were personally redeployed to assist with the care of COVID-19 patients. A considerable proportion of residents felt that the COVID-19 pandemic had a negative impact on their education (58.1 percent) and wellness (84.8 percent). Residents found virtual curriculum effective and meaningful, and viewed an average of 4.2 lectures weekly. Although most residents did not anticipate a change in career path, some reported negative consequences on job prospects or fellowship. CONCLUSIONS: The COVID-19 pandemic had a considerable impact on U.S. plastic surgery education and wellness. Although reductions in case volume may be temporary, this may represent a loss of critical, supervised clinical experience. Some effects may be positive, such as the development of impactful virtual lectures that allow for cross-institutional curriculum.


Subject(s)
Attitude of Health Personnel , COVID-19 , Health Status , Internship and Residency , Students, Medical/psychology , Surgery, Plastic/education , Adult , Career Choice , Cross-Sectional Studies , Curriculum , Education, Distance/methods , Education, Distance/organization & administration , Education, Distance/trends , Female , Humans , Internship and Residency/methods , Internship and Residency/organization & administration , Internship and Residency/trends , Male , Mental Health , Physical Distancing , Social Support , Stress, Psychological , Surgery, Plastic/organization & administration , Surgery, Plastic/trends , Surveys and Questionnaires , United States
4.
Plast Reconstr Surg ; 148(1): 133e-139e, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1284960

ABSTRACT

SUMMARY: The coronavirus disease of 2019 pandemic became a global threat in a matter of weeks, with its future implications yet to be defined. New York City was swiftly declared the epicenter of the pandemic in the United States as case numbers grew exponentially in a matter of days, quickly threatening to overwhelm the capacity of the health care system. This burgeoning crisis led practitioners across specialties to adapt and mobilize rapidly. Plastic surgeons and trainees within the New York University Langone Health system faced uncertainty in terms of future practice, in addition to immediate and long-term effects on undergraduate and graduate medical education. The administration remained vigilant and adaptive, enacting departmental policies prioritizing safety and productivity, with early deployment of faculty for clinical support at the front lines. The authors anticipate that this pandemic will have far-reaching effects on the future of plastic surgery education, trends in the pursuit of elective surgical procedures, and considerable consequences for certain research endeavors. Undoubtedly, there will be substantial impact on the physical and mental well-being of health care practitioners across specialties. Coordinated efforts and clear lines of communication between the Department of Plastic Surgery and its faculty and trainees allowed a concerted effort toward the immediate challenge of tempering the spread of coronavirus disease of 2019 and preserving structure and throughput for education and research. Adaptation and creativity have ultimately allowed for early rebooting of in-person clinical and surgical practice. The authors present their coordinated efforts and lessons gleaned from their experience to inform their community's preparedness as this formidable challenge evolves.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/standards , Pandemics/prevention & control , Surgery, Plastic/trends , Academic Medical Centers/standards , Academic Medical Centers/statistics & numerical data , Academic Medical Centers/trends , COVID-19/prevention & control , COVID-19/transmission , Education, Medical, Graduate/organization & administration , Education, Medical, Graduate/standards , Education, Medical, Graduate/trends , Elective Surgical Procedures/education , Elective Surgical Procedures/standards , Elective Surgical Procedures/trends , Faculty/organization & administration , Faculty/psychology , Faculty/statistics & numerical data , Forecasting , Humans , Internship and Residency/statistics & numerical data , New York City/epidemiology , Personnel Staffing and Scheduling/organization & administration , Personnel Staffing and Scheduling/trends , Reconstructive Surgical Procedures/education , Reconstructive Surgical Procedures/standards , Reconstructive Surgical Procedures/trends , Surgeons/organization & administration , Surgeons/psychology , Surgeons/statistics & numerical data , Surgery, Plastic/education , Surgery, Plastic/organization & administration , Surgery, Plastic/standards , Surveys and Questionnaires/statistics & numerical data , Uncertainty , Universities/standards , Universities/statistics & numerical data , Universities/trends
5.
Plast Reconstr Surg ; 148(1): 168e-169e, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1263729

Subject(s)
COVID-19/prevention & control , Infection Control/organization & administration , Pandemics/prevention & control , Surgery Department, Hospital/organization & administration , Surgery, Plastic/organization & administration , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing/standards , COVID-19 Testing/statistics & numerical data , COVID-19 Testing/trends , Egypt/epidemiology , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , Elective Surgical Procedures/trends , Health Policy , Humans , Infection Control/standards , Infection Control/statistics & numerical data , Infection Control/trends , Reconstructive Surgical Procedures/standards , Reconstructive Surgical Procedures/statistics & numerical data , Reconstructive Surgical Procedures/trends , SARS-CoV-2/isolation & purification , Surgery Department, Hospital/standards , Surgery Department, Hospital/statistics & numerical data , Surgery Department, Hospital/trends , Surgery, Plastic/standards , Surgery, Plastic/statistics & numerical data , Surgery, Plastic/trends , Telemedicine/organization & administration , Telemedicine/standards , Telemedicine/statistics & numerical data , Tertiary Care Centers/organization & administration , Tertiary Care Centers/standards , Tertiary Care Centers/statistics & numerical data , Tertiary Care Centers/trends , Triage/organization & administration , Triage/standards , Triage/statistics & numerical data , Triage/trends
9.
J Plast Reconstr Aesthet Surg ; 74(3): 644-710, 2021 03.
Article in English | MEDLINE | ID: covidwho-912071

ABSTRACT

The SARS-CoV-2 cornovirus disease (COVID-19) pandemic has significantly affected referrals of new suspected cancers from primary care to specialist services in the National Health Service (NHS) across the UK.  Amongst the many factors causing delay, such as fear and uncertainty about COVID-19 transmission, reluctance to seek medical attention for cancer sypmtoms and avoiding additional pressure on NHS services, we anticipate a surge in urgent skin cancer referrals to our plastic surgery service as we enter a post-COVID recovery phase.  On the basis of previous referral data and statistical forecasting, we share our predicted numbers against our actual number of urgent skin cancer referrals for the COVID-19 period and, based on this analysis, encourage all cancer services to prepare and allocate resources appropriately for the busy months to follow.


Subject(s)
COVID-19 , Referral and Consultation , Skin Neoplasms , Surgery, Plastic , Time-to-Treatment/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Critical Pathways/trends , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Health Services Misuse/prevention & control , Health Services Misuse/statistics & numerical data , Humans , Infection Control/methods , Infection Control/organization & administration , Needs Assessment , Referral and Consultation/organization & administration , Referral and Consultation/trends , SARS-CoV-2 , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/surgery , Surgery, Plastic/methods , Surgery, Plastic/organization & administration , Surgery, Plastic/trends , United Kingdom/epidemiology
10.
J Plast Reconstr Aesthet Surg ; 74(4): 890-930, 2021 04.
Article in English | MEDLINE | ID: covidwho-912070

ABSTRACT

The COVID-19 outbreak is a global problem affecting the world in many respects. In the medical field, its impact on surgical branches as well as clinical branches is inevitable. From the plastic surgery perspective, the COVID-19 outbreak affects the number and distribution of surgeries, patient admissions and educational activities. Although these impacts are predictable, it is beneficial to document these data that would contribute to the proper response to a similar crisis in the future. From this standpoint, the present study aims to analyze the effect of the COVID-19 pandemic on plastic surgery practice in some aspects. Epidemiologic data of the two-time frames, routine period, and pandemic period of plastic surgery were reviewed retrospectively. The ratios of the listed data were compared between the two periods; admissions to the outpatient clinic, surgeries, consultations, anesthesia type, hospitalizations, and demographic data. While the number of outpatient clinic patients was 3511 in the routine period, it was 490 in the pandemic period. Compared to the routine period, the number of surgical interventions was decreased from 793 to 129 during the pandemic period. In particular, a statistically significant increase was observed in the rate of hand trauma and maxillofacial trauma cases during the pandemic period compared with the routine period (p < 0.001, and p = 0.032, respectively). Therefore, high rates of hand trauma and maxillofacial trauma should be taken into consideration when making arrangements such as personnel distribution, use of medical resources, and regulation of hospital infrastructure in extraordinary situations like COVID-19 pandemics.


Subject(s)
Ambulatory Surgical Procedures/statistics & numerical data , COVID-19/epidemiology , Hospitalization/statistics & numerical data , Infection Control/organization & administration , Reconstructive Surgical Procedures/statistics & numerical data , Surgery, Plastic/organization & administration , COVID-19/prevention & control , COVID-19/transmission , Humans
12.
Acta Biomed ; 91(3): ahead of print, 2020 07 28.
Article in English | MEDLINE | ID: covidwho-843626

ABSTRACT

During the COVID-19 pandemic, surgical elective procedures were stopped in our plastic surgery unit. Limitations for consultations and for follow-up of previous surgical procedures were imposed in order to minimize the risk of contagion in waiting rooms and outpatient clinics. We have identified telemedicine as an alternative way to follow patients during the lockdown. Nevertheless, we have experienced different difficulties. We have not had the possibility to use a secure teleconferencing software. In our unit we had not technological devices. Surgeons in our department were not able to use remote video technology for patient management. Guidelines for an appropriate selection of patients which could be served via telemedicine had to be created. Telemedicine must be regulated by healthcare organizations for legal, ethical, medico-legal and risk management aspects. Even if we have experienced an important need to use telematic solutions during the COVID-19 lockdown, liability and risk management issues has greatly limited this possibility in our unit. The need of telemedicine in the time of COVID-19 pandemic has encouraged us to implement future virtual encounters in order to reduce unnecessary in-person visits by taking into consideration all legal, ethical and medico-legal aspects.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Disease Transmission, Infectious/prevention & control , Pneumonia, Viral/epidemiology , Reconstructive Surgical Procedures/methods , Risk Management/methods , Surgery, Plastic/organization & administration , Telemedicine/methods , COVID-19 , Coronavirus Infections/transmission , Humans , Pandemics , Pneumonia, Viral/transmission , SARS-CoV-2
14.
J Plast Reconstr Aesthet Surg ; 74(2): 401-406, 2021 02.
Article in English | MEDLINE | ID: covidwho-778528

ABSTRACT

At the time of writing, coronavirus disease-2019 (COVID-19) has affected 6.42 million people globally and over 380,000 deaths, with the United Kingdom now having the highest death rate in Europe. The plastic surgery department at Leeds Teaching Hospitals put necessary steps in place to maintain an excellent urgent elective and acute service whilst also managing COVID-positive medical patients in the ward. We describe the structures and pathways implemented together with complex decision-making, which has allowed us to respond early and effectively. We hope these lessons will prove a useful tool as we look to open conversations around the recovery of normal activity.


Subject(s)
COVID-19 , Hospital Departments , Infection Control , Neoplasms/surgery , Surgery, Plastic , Wounds and Injuries/surgery , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Change Management , Child , Disease Transmission, Infectious/prevention & control , Elective Surgical Procedures , Hospital Departments/methods , Hospital Departments/organization & administration , Hospital Departments/statistics & numerical data , Humans , Infection Control/methods , Infection Control/standards , Neoplasms/epidemiology , Reconstructive Surgical Procedures , SARS-CoV-2 , Surgery, Plastic/education , Surgery, Plastic/organization & administration , Surgery, Plastic/trends , Teaching/organization & administration , Teaching/trends , United Kingdom/epidemiology , Wounds and Injuries/epidemiology
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