Our Summary

This research paper discusses how a level 1 trauma center managed to care for patients with hand injuries during the COVID-19 pandemic. The pandemic has caused many healthcare resources to be redirected towards treating severe COVID-19 patients, which could potentially impact the ability to treat other seriously ill or injured patients. The study looks at patients with hand injuries visiting the Plastic Surgery department from March to May 2020.

Out of 102 hand injuries, five patients were COVID-19 positive. The majority of patients were males and the average age was around 29 years. Most of these injuries were treated non-surgically or through minor procedures under local anaesthetic. Patients were discharged as soon as they were comfortable, and a few who had more serious procedures were discharged after four days of monitoring.

The study found that early complications and loss to follow-up were relatively low. The authors conclude that essential trauma care must continue during the pandemic, but with careful use of resources and ensuring safety for both patients and healthcare workers. They suggest the use of teleconsultation, non-operative management, and local anaesthesia where possible to help manage this.

FAQs

  1. How did the level 1 trauma center manage to treat hand injuries during the pandemic?
  2. What were the common treatment procedures for hand injuries during the pandemic?
  3. What strategies are suggested by the authors to continue essential trauma care during a pandemic?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand surgery is to follow post-operative instructions carefully to ensure proper healing and minimize the risk of complications. This may include keeping the hand elevated, avoiding strenuous activities, and attending follow-up appointments as scheduled. It is important for patients to communicate any concerns or changes in symptoms to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for hand surgery include those with:

  1. Traumatic injuries such as fractures, dislocations, tendon injuries, nerve injuries, and lacerations
  2. Chronic conditions such as carpal tunnel syndrome, trigger finger, arthritis, and Dupuytren’s contracture
  3. Congenital anomalies such as polydactyly, syndactyly, and other hand deformities
  4. Soft tissue injuries such as burns, infections, and soft tissue tumors
  5. Degenerative conditions such as osteoarthritis and rheumatoid arthritis

Overall, patients who have persistent pain, limited function, or cosmetic concerns related to their hand condition may be recommended for hand surgery. It is important for patients to consult with a hand surgeon to determine the most appropriate treatment plan for their specific condition.

Timeline

Before hand surgery:

  1. Patient sustains a hand injury and seeks medical attention.
  2. Initial evaluation and assessment of the injury by a healthcare provider.
  3. Diagnostic imaging such as X-rays or MRI may be performed to determine the extent of the injury.
  4. Treatment plan is discussed with the patient, which may include non-surgical options or surgical intervention.
  5. Pre-operative preparations such as blood tests, medical history review, and consent forms are completed.

After hand surgery:

  1. Patient undergoes hand surgery to repair the injury.
  2. Post-operative care and monitoring in the recovery room.
  3. Pain management and wound care instructions are provided to the patient.
  4. Follow-up appointments scheduled for wound checks, suture removal, and rehabilitation.
  5. Physical therapy may be recommended to aid in recovery and regain hand function.
  6. Patient is discharged once they are deemed stable and able to manage at home.
  7. Long-term follow-up to monitor healing progress and address any complications that may arise.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery include:

  1. What specific type of hand surgery do you recommend for my injury or condition?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Will I need to undergo any additional tests or evaluations before the surgery?
  5. What type of anesthesia will be used during the surgery?
  6. How many of these surgeries have you performed before, and what is your success rate?
  7. Will I need to stay in the hospital overnight after the surgery?
  8. What can I do to prepare for the surgery and optimize my outcome?
  9. What kind of follow-up care will I need after the surgery?
  10. Are there any alternative treatments or therapies that I should consider before deciding on surgery?

Reference

Authors: Saha S, Dash S, Ansari MT, Bichupuriya AD, Gupta AK, Singhal M. Journal: J Hand Surg Asian Pac Vol. 2021 Mar;26(1):84-91. doi: 10.1142/S2424835521500132. PMID: 33559584