Bashar Ahm, Rahman Mm, Islam Mf, Ghosh Sk, Reza S, M. S, Ahmed Smp, Sabah Mn, Islam Mm, Jamil Ms, Hossain Sz
{"title":"南亚国家2019冠状病毒病大流行期间的血管护理服务:对肢体保留的影响","authors":"Bashar Ahm, Rahman Mm, Islam Mf, Ghosh Sk, Reza S, M. S, Ahmed Smp, Sabah Mn, Islam Mm, Jamil Ms, Hossain Sz","doi":"10.26420/austinjsurg.2021.1279","DOIUrl":null,"url":null,"abstract":"Objective: Covid-19 continues its negative impact on limb salvage in patients with limb ischemia and vascular trauma. Bangladesh fought the 1st and 2nd waves of the Covid-19 pandemic during April through August, 2020 and in April-May, 2021, respectively. Infections have been rising once again since early June 2021 to reach a positivity rate over 30%. With limited resources, vascular surgical care during the pandemic has been an unprecedented challenge for a developing country like Bangladesh. As a small vascular community, we have adopted a strategy focused on conserving essential resources including manpower while delivering essential vascular care. The present study evaluates the effectiveness of our pandemic-time guideline-based working strategy with a focus on limb salvage. Methods: Essential vascular services were provided by customized teams throughout the Covid-19 pandemic at two referral centers according to our working guidelines. Data were analyzed and key limb salvage outcomes compared between the two pandemic waves by chi-square test. Results: A total of 1792 vascular surgical cases were addressed during the pandemic- over 90% of which involved limb or life-saving procedures. Overall mortality was 0.6% and overall limb salvage rate for acute and Chronic Limb Threatening Ischemia (CLTI) were 95.3% and 76.8%, respectively. Limb salvage rate for CLTI was significantly higher in the 2nd wave compared with the 1st (P<0.05). Rate of Covid-19 infection among vascular workforce was about 20%. Conclusion: Emergency-focused altered working guideline has produced satisfactory results in terms of continuing emergency vascular services, improving limb salvage and safeguarding vascular workforce during Covid-19 pandemic in a developing country. Conservation of resources including manpower remains relevant in the context of a highly probable 3rd wave of infection.","PeriodicalId":91056,"journal":{"name":"Austin journal of surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vascular Care Services during the Covid-19 Pandemic in a South Asian Country: Implications for Limb Salvage\",\"authors\":\"Bashar Ahm, Rahman Mm, Islam Mf, Ghosh Sk, Reza S, M. S, Ahmed Smp, Sabah Mn, Islam Mm, Jamil Ms, Hossain Sz\",\"doi\":\"10.26420/austinjsurg.2021.1279\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: Covid-19 continues its negative impact on limb salvage in patients with limb ischemia and vascular trauma. Bangladesh fought the 1st and 2nd waves of the Covid-19 pandemic during April through August, 2020 and in April-May, 2021, respectively. Infections have been rising once again since early June 2021 to reach a positivity rate over 30%. With limited resources, vascular surgical care during the pandemic has been an unprecedented challenge for a developing country like Bangladesh. As a small vascular community, we have adopted a strategy focused on conserving essential resources including manpower while delivering essential vascular care. The present study evaluates the effectiveness of our pandemic-time guideline-based working strategy with a focus on limb salvage. Methods: Essential vascular services were provided by customized teams throughout the Covid-19 pandemic at two referral centers according to our working guidelines. Data were analyzed and key limb salvage outcomes compared between the two pandemic waves by chi-square test. Results: A total of 1792 vascular surgical cases were addressed during the pandemic- over 90% of which involved limb or life-saving procedures. Overall mortality was 0.6% and overall limb salvage rate for acute and Chronic Limb Threatening Ischemia (CLTI) were 95.3% and 76.8%, respectively. Limb salvage rate for CLTI was significantly higher in the 2nd wave compared with the 1st (P<0.05). Rate of Covid-19 infection among vascular workforce was about 20%. Conclusion: Emergency-focused altered working guideline has produced satisfactory results in terms of continuing emergency vascular services, improving limb salvage and safeguarding vascular workforce during Covid-19 pandemic in a developing country. Conservation of resources including manpower remains relevant in the context of a highly probable 3rd wave of infection.\",\"PeriodicalId\":91056,\"journal\":{\"name\":\"Austin journal of surgery\",\"volume\":\"11 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-10-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Austin journal of surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26420/austinjsurg.2021.1279\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Austin journal of surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26420/austinjsurg.2021.1279","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Vascular Care Services during the Covid-19 Pandemic in a South Asian Country: Implications for Limb Salvage
Objective: Covid-19 continues its negative impact on limb salvage in patients with limb ischemia and vascular trauma. Bangladesh fought the 1st and 2nd waves of the Covid-19 pandemic during April through August, 2020 and in April-May, 2021, respectively. Infections have been rising once again since early June 2021 to reach a positivity rate over 30%. With limited resources, vascular surgical care during the pandemic has been an unprecedented challenge for a developing country like Bangladesh. As a small vascular community, we have adopted a strategy focused on conserving essential resources including manpower while delivering essential vascular care. The present study evaluates the effectiveness of our pandemic-time guideline-based working strategy with a focus on limb salvage. Methods: Essential vascular services were provided by customized teams throughout the Covid-19 pandemic at two referral centers according to our working guidelines. Data were analyzed and key limb salvage outcomes compared between the two pandemic waves by chi-square test. Results: A total of 1792 vascular surgical cases were addressed during the pandemic- over 90% of which involved limb or life-saving procedures. Overall mortality was 0.6% and overall limb salvage rate for acute and Chronic Limb Threatening Ischemia (CLTI) were 95.3% and 76.8%, respectively. Limb salvage rate for CLTI was significantly higher in the 2nd wave compared with the 1st (P<0.05). Rate of Covid-19 infection among vascular workforce was about 20%. Conclusion: Emergency-focused altered working guideline has produced satisfactory results in terms of continuing emergency vascular services, improving limb salvage and safeguarding vascular workforce during Covid-19 pandemic in a developing country. Conservation of resources including manpower remains relevant in the context of a highly probable 3rd wave of infection.