Qazi Uzair A, Sutton Julianne, Farner Scott C, Bhandari Laxminarayan
Hand Surgery, Kleinert Kutz and Associates for Hand and Microsurgery, Louisville, USA.
Research, Kleinert Kutz and Associates for Hand and Microsurgery, Louisville, USA.
Cureus. 2020 Dec 14;12(12):e12072. doi: 10.7759/cureus.12072.
Objective The purpose of this study was to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on the practice of hand and upper extremity surgeons. Methods We assessed how the pandemic affected the practice on multiple fronts including professional, personal, and practice aspects. The survey was conducted through an online questionnaire that had six sections: demographics, clinic, elective surgery, emergency surgery, urgent surgery, and human resources. The survey was sent to 586 Kleinert Society members who are all practicing hand and upper extremity surgeons. Results We received 35 responses from the United States and 53 from the rest of the world. Based on our findings, the clinic volume was reduced by >50% in the early stages, subsequently returning to a level that was 25-50% lower than pre-COVID-19 times in later stages. A corresponding decrease in elective surgeries was also noted. The need for preoperative COVID-19 tests added to the logistics of surgery, causing delays of three to six hours for emergency cases and >24 hours for urgent cases. The hand surgeons witnessed multiple furloughs, layoffs, and even COVID-19 infections among nursing and support staff. Most hand surgeons continued to perform urgent and emergency surgeries during the pandemic. The application of telemedicine was not popular and had multiple drawbacks. Hand surgeons are modifying their practice by adopting measures such as social distancing, reducing the clinic volume, and using personal protective equipment (PPE). Conclusions As COVID-19 is likely to prevail for the foreseeable future, these measures are here to stay. The initial reduction in the clinic and elective volume has improved but has not reached pre-COVID-19 levels, suggesting a slow recovery. As reopening measures will lead to more people rejoining employment, subsequently, more patients with hand-related conditions are likely to present to the clinics. Rapid COVID-19 testing and supply of PPEs will play a crucial role in the near future to enable hand surgeons to continue their service while taking care of their personal health.
目的 本研究旨在确定2019年冠状病毒病（COVID-19）大流行对手和上肢外科医生执业的影响。方法 我们评估了大流行在多个方面如何影响其执业，包括专业、个人和执业方面。该调查通过一份在线问卷进行，问卷有六个部分：人口统计学、诊所、择期手术、急诊手术、紧急手术和人力资源。该调查发送给了586名Kleinert学会成员，他们均为执业手和上肢外科医生。结果 我们收到了来自美国的35份回复和来自世界其他地区的53份回复。根据我们的研究结果，诊所业务量在早期减少了50%以上，随后在后期恢复到比COVID-19之前水平低25%-50%的水平。择期手术也相应减少。术前COVID-19检测的需求增加了手术的后勤负担，导致急诊病例延迟三到六个小时，紧急病例延迟超过24小时。手外科医生目睹了护理和支持人员多次休假、裁员，甚至感染COVID-19。大多数手外科医生在大流行期间继续进行紧急和急诊手术。远程医疗的应用并不受欢迎，且有多个缺点。手外科医生正在通过采取社交距离、减少诊所业务量和使用个人防护装备（PPE）等措施来调整他们的执业方式。结论 由于COVID-19在可预见的未来可能会持续存在，这些措施将持续下去。诊所和择期业务量的最初减少有所改善，但尚未达到COVID-19之前的水平，表明恢复缓慢。随着重新开放措施将导致更多人重新就业，随后，更多手部相关疾病的患者可能会前往诊所就诊。快速的COVID-19检测和PPE的供应在不久的将来将发挥关键作用，以使手外科医生能够在照顾好自身健康的同时继续提供服务。
