Leonardo Garutti, Federico Tamborini, Alessandro Fagetti, Tommaso Baroni, Elisa Bascialla, Andrea Minini, Mario Cherubino, Luigi Valdatta
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引用次数: 0
Abstract
Background: Nerve injuries are a common occurrence among hand injuries, which at the time of the COVID-19 emergency, did not appear to have reduced their incidence. The treatment of these injuries is urgent, but the pandemic has led to a reduction in the availability of resources and a consequent reorganization of activities. Principles about Wide-Awake Local Anesthesia No Tourniquet (WALANT) in hand surgery expressed by LaLonde helped hand surgeons to adapt to this new condition by demonstrating a possible outpatient pathway for the treatment of hand traumatic conditions. In the present study, we bring our experience in nerve repair at time of COVID-19 emergency.
Methods: We retrospectively enrolled in this study all patients surgically treated for a peripheral nerve injury (PNI) during the COVID-19 emergency period from March 2020 to March 2022. Demographical, anamnestic, surgical, and postoperative data were recorded and analyzed. Persisting Tinel was set as the primary outcome, while hypoesthesia and other complications as secondary outcomes.
Results: Thirty-six patients have been enrolled. Despite some difference in group homogeneity in term of hypertension and multi-digital involvement, we registered no difference in term of outcomes (P > 0.05) between patient operated in surgical theater and in outpatient clinic and between the various techniques of nerve repair employed (P > 0.05).
Conclusions: Nerve repair on an outpatient facility is technically feasible and was found in this study to be safe and effective. Compared to hospitalization, the outpatient setting has a more "agile" organization and lower costs, making it preferable in selected cases.Level of evidence: Level IV, Therapeutic.
期刊介绍：
Europe has always been an area of dynamic development in plastic surgery. Its great strength has been the lack of uniformity of this development due to differing cultures, different traditions, and differing medical and surgical philosophies. Over the recent years, these changes have been even more striking and rapid. The European Journal of Plastic Surgery creates a focal point for the input of new advances in clinical techniques and in research. It thus becomes an educational vehicle. In addition to this, the journal provides information on what is going on elsewhere in the world, and it is also willing to accept contributions from outside of Europe. Fields of interest include general plastic and reconstructive surgery, head and neck surgery, aesthetic and craniofacial surgery, hand surgery, microsurgery, treatment of bones, trauma, burn management and basic research related to all aspects of plastic surgery.Submitted articles are first evaluated by the Editor in Chief and if judged appropriate, are peer-reviewed by at least two selected experts. Reviewers may be plastic surgeons or other surgical/ medical specialists with expertise in specific areas of research. Manuscripts provisionally accepted for publication may be returned to the author for corrections or clarifications, in response to suggestions by the Editorial Board or external reviewers, prior to final acceptance. Online submission and peer review for rapid online publication are offered through the Editorial Manager System. The system creates a PDF version of the submitted article for peer review, revision and proofing. All correspondence, including the request for revisions and final decision, is managed by e-mail. Authors are guided step by step through the full process and are kept up to date on the article’s progress at every stage. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.Reports of animal experiments must state that the ''Principles of laboratory animal care'' (NIH publication No. 86-23, revised in 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.Acknowledgments of people, grants, funds, etc. should be placed in a separate section before the reference list. The names of funding organizations should be written in full. Authors are also required to disclose any relationships with public or private commercial or noncommercial entities, any institutional affiliations, or any personal associations that might pose a conflict of interest.The Editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfill the above-mentioned requirements.
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