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Sinclair Guy posted an update 12 days ago
Background Burn and trauma injuries need emergency care and resuscitation, which required uninterrupted delivery of inpatient care services during the coronavirus disease 2019 (COVID-19) pandemic. Burn patients are physiologically immunocompromised, increasing the risk of COVID-19 infection in them. This study analyzes the impact of COVID-19 pandemic on patient trends in a burn and plastic unit and assesses the effect of COVID-19 infection in burns. Methods This single-center, retrospective observational case-control study was conducted in the Department of Burns, Plastic and Maxillofacial Surgery of a tertiary care hospital in New Delhi, India. Patient data was collected from April 1, 2019 to August 10, 2019 and from April 1, 2020 to August 10, 2020. All data of burns and trauma patients collected was analyzed and compared. Results There were total 350 admissions during COVID time period and 562 admissions during non-COVID time period. The admission rate, type of burn injury, and death rate did not vary significantly during the two time periods. Thermal burn was the most common type of burn injury. There were total 18 cases diagnosed to be COVID-19 positive during the pandemic. There were two deaths among COVID-19 positive burn cases. Conclusion This study finds no difference in patient patterns during COVID and non-COVID time period. Amongst burn patients, no increased risk of COVID-19 infection is seen with larger body surface area of burns. No increase in mortality is seen in burn patients infected with COVID-19.Background Many aspects of life have been changed, after the starting of the pandemic. Modifications and improvisation in our day-to-day activities is now a new norm. During the pandemic period, continuation academic activities and conductance of examination is difficult but essential. GDC-0879 cost We are sharing our experience of conductance of MCh examination during the pandemic and preparations made. This article also discussed the future of surgical assessment examination, use of technology in surgical assessment changing times. Methods Procedural flow of the examination, Logistics and arrangements were planned and checked. Reliability and validity of questions were maintained by providing a similar set of questions and stepwise objective assessment. Assessment and feedback by the examinees and examiners on the pattern and conductance of examination were assessed by a Likert scale. Results We found, 73% agreed examination patterns were able to test the knowledge fairly. While 80 % believed the pattern was the same for all the candidates. All the stakeholders agreed the examination conducted in a Safe and stress-free atmosphere and use of technology helpful. Fifty- three % agreed the case scenarios correctly simulate the clinical presentations. Lastly, 66 % felt the examination process is adequate for summative assessment. Conclusions It is vital to reflect regarding the need for a uniform module to handle changing scenarios keeping the integrity and quality of the examination. Interactive screen, mannequin, and 3D model will be useful in the examination. In future, standardized examination modules for the surgical trainees will be required to perform a comprehensive assessment.Background Surgical treatment of sacrococcygeal pilonidal sinus disease (SPSD) consists of radical excision of the entire tract and treatment of the resultant raw area. Here, the authors have reviewed the results of the rotation flap for closure of the SPSD. Aim This study aims to evaluate the outcomes following SPSD excision and rotation flap closure. Materials and Methods All patients were treated for SPSD with excision and closure using a rotation flap from January 2010 to September 2018. Cases having a follow-up of at least 6 months post surgery were evaluated. Result A total of 52 patients were included in the study; 42 cases were of primary disease while 10 were of recurrent disease. The patients’ follow-up records on the 3rd day, 10th day, 1 month, and 6 months were evaluated. None of the patients showed any signs of recurrence on follow-ups. One patient developed a hematoma on the third day post surgery which was treated conservatively. One patient developed a seroma in the perianal region on the fifth postoperative day which required aspiration. Both these patients healed well subsequently. Conclusion Rotation flap is a (simple and reliable) treatment option for closure of postexcision SPSD defect. It not only takes the tension away from suture line, but also pushes the gluteal fat from the sides into the midline, obliterating the deep crevice of the natal cleft which is believed to be one of the important factors in the causation of SPSD, thus minimizing recurrence.Background Deep sternal wound infections (DSWI) following median sternotomy are initially treated by the cardiothoracic surgeons and are referred to a plastic surgical unit late in the course of time. Methods This is a retrospective review done in a tertiary care teaching institute from January 2005 to June 2018 and the data of 72 patients who had DSWI out of 4,214 patients who underwent median sternotomy for coronary artery bypass grafting (CABG) was collected with respect to the duration between CABG and presentation of DSWI as well as time of referral to a plastic surgery unit. We defined early referral as 15 days. Both groups were compared with respect to multiple parameters as well as early and late postoperative course, postoperative complications, and mortality. Results The early group had 33 patients, while the late group had 39 patients. The number of procedures done by the cardiothoracic team before referral to the plastic surgery unit is significant ( p = 0.002). The average duration from the presentation of DSWI to definitive surgery was found to be 16.58 days in the early group and 89.36 days in the late group. The rest of the variables that were compared in both the groups did not have significant differences. Conclusion There is no statistical difference between early and late referral to plastic surgery in terms of mortality and morbidity. Yet, early referrals could lead to highly significant reduction in total duration of hospital stay, wound healing, and costs. Early referral of post-CABG DSWIs to Plastic surgeons by the cardiothoracic surgeons is highly recommended.