British Association of Oral and Maxillofacial Surgeons, Royal College of Surgeons of England, 35/43 Lincoln's Inn Fields, London WC2A 3PE.
Queen Victoria Hospitals Foundation Trust, East Grinstead, Essex, RH19 3DZ.
Br J Oral Maxillofac Surg. 2021 Oct;59(8):867-874. doi: 10.1016/j.bjoms.2020.12.021. Epub 2021 Jan 8.
We assess the effect of coronavirus disease 2019 (COVID-19) on UK oral and maxillofacial (OMF) trauma services and patient treatment during the first wave of the pandemic. From 1 April 2020 until 31 July 2020, OMF surgery units in the UK were invited to prospectively record all patients presenting with OMF trauma. Information included clinical presentation, mechanism of injury, how it was managed, and whether or not treatment included surgery. Participants were also asked to compare the patient's care with the treatment that would normally have been given before the crisis. Twenty-nine units across the UK contributed with 2,229 entries. The most common aetiology was mechanical fall (39%). The most common injuries were soft tissue wounds (52%) and, for hard tissues, mandibular fractures (13%). Of 876 facial fractures, 79 patients' treatment differed from what would have been normal pre-COVID, and 33 had their treatment deferred. Therefore the care of 112 (14%) patients was at variance with normal practice because of COVID restrictions. The pattern of OMFS injuries changed during the first COVID-19 lockdown. For the majority, best practice and delivery of quality trauma care continued despite the on-going operational challenges, and only a small proportion of patients had changes to their treatment. The lessons learnt from the first wave, combined with adequate resources and preoperative testing of patients, should allow those facial injuries in the second wave to receive best-practice care.
我们评估了 2019 年冠状病毒病（COVID-19）对英国口腔颌面（OMF）创伤服务以及大流行第一波期间患者治疗的影响。从 2020 年 4 月 1 日至 2020 年 7 月 31 日，英国的 OMF 外科单位被邀请前瞻性地记录所有因 OMF 创伤就诊的患者。信息包括临床表现、损伤机制、处理方式以及是否包括手术。参与者还被要求将患者的护理与危机前通常会给予的治疗进行比较。英国各地的 29 个单位共提供了 2229 条记录。最常见的病因是机械性跌倒（39%）。最常见的损伤是软组织伤口（52%），硬组织损伤为下颌骨骨折（13%）。在 876 例面部骨折中，有 79 例患者的治疗与 COVID 前的正常治疗不同，有 33 例患者的治疗被推迟。因此，由于 COVID 限制，有 112 名（14%）患者的护理与正常做法不同。在第一次 COVID-19 封锁期间，OMFS 损伤的模式发生了变化。对于大多数患者，尽管持续存在运营挑战，但仍继续实施最佳实践并提供高质量的创伤护理，只有少数患者的治疗发生了变化。从第一波中吸取的经验教训，加上充足的资源和对患者的术前检查，应使第二波中的那些面部损伤能够得到最佳实践的护理。
