Zindrou Darco, Halle Martin, Jakobsson Stina
Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Plast Reconstr Surg Glob Open. 2022 Apr 25;10(4):e4309. doi: 10.1097/GOX.0000000000004309. eCollection 2022 Apr.
Since its outbreak, the COVID-19-pandemic has had a tremendous impact on healthcare systems worldwide. We conducted a comparative study to analyze the pandemic's consequence on microsurgical reconstructions at a reconstructive plastic surgery center in Sweden.
All free flaps performed at a single center between March 2019 and 2021 were analyzed. The patient cohort was divided into two groups, with a period of 1 year in each group: non-COVID-19 year and COVID-19 year. The periods were compared regarding the number and type of surgeries and patient characteristics.
In the year prior to the pandemic, 123 free flap surgeries were performed, compared with 103 surgeries during the COVID-19 year. There was a significant shift in the most common site for free flap reconstruction: from the breast [which decreased by 42% (66-38)] to head and neck [which increased by 22% (41-50); OR 0.53 ( = 0.02)]. This was also reflected by a significant increase in hospital stay for free flap patients during the COVID-19 year ( = 0.02).
During the COVID-19 pandemic, a shift was seen from breast reconstructions toward head and neck reconstructions as the most common free flap procedure performed. An increasing backlog of elective breast reconstructions demands increased resources and tougher priorities, which challenge the healthcare system in the post-COVID-19 era.
自新冠疫情爆发以来，它对全球医疗系统产生了巨大影响。我们进行了一项比较研究，以分析疫情对瑞典一家整形重建外科中心显微外科重建手术的影响。
对2019年3月至2021年期间在单一中心进行的所有游离皮瓣手术进行分析。患者队列分为两组，每组为期1年：非新冠疫情年份和新冠疫情年份。比较这两个时期的手术数量和类型以及患者特征。
在疫情爆发前的一年，进行了123例游离皮瓣手术，而在新冠疫情年份为103例。游离皮瓣重建最常见部位发生了显著变化：从乳房部位[减少了42%（66 - 38）]转变为头颈部[增加了22%（41 - 50）；比值比为0.53（P = 0.02）]。这也反映在新冠疫情年份游离皮瓣患者住院时间显著增加（P = 0.02）。
在新冠疫情期间，游离皮瓣手术最常见的术式从乳房重建转向了头颈部重建。择期乳房重建积压病例的增加需要更多资源和更严格的优先级安排，这对新冠疫情后时代的医疗系统构成了挑战。
