1008 Impact of COVID-19 Vaccination-Based Triaging on Recovery of Services for Plastic Surgery Hand Trauma in a Plastic Surgery Tertiary Referral Centre

Aim

Evaluate the impact vaccination-based-triaging on recovery of operative services.

Method

Data was collected retrospectively on 120 patients who underwent surgical management for closed hand fractures, nerve injuries, and tendon injuries. Forty were in the pre-covid group (Jan-Mar 2019), 40 in the post-covid pre-vaccine group (Jan-Mar 2022), and 40 in the post-covid post-vaccine group (Jul-Sep 2022).

Outcome measures:Average number of days between decision to operate and operation (operative delay)Adherence to operative timing requirements, as set by the British Society for Surgery of the Hand (BSSH)

Results

In the post-covid post-vaccine group, operative delay was shorter than in the post-covid pre-vaccine group for hand fractures (3.6 vs 3.9) nerve injuries (3.8 vs 2.5), and tendon injuries (2.1 vs 2.2). Overall, the difference was not statistically significant (3.3 vs 2.7, p = 0.2526).

BSSH operative timing requirements were met in a higher proportion of patients for hand fractures (93% vs 85%), nerve repairs (100% vs 87%), tendon repairs (89% vs 85%) and overall (89% vs 85%).

In the pre-covid group, operative delay was shorter than both post-covid groups for hand fractures (2.5), nerve injuries (1.8), and tendon injuries (1.4). Overall, the difference was statistically significant compared to the post-covid pre-vaccine (1.9 vs 3.3, p = 0.0024) and pre-covid post-vaccine groups (2.7 vs 1.9, p = 0.0238).

Overall, BSSH operative timing requirements were met for a higher proportion of patients than both pre-covid groups (100% vs 89%).

Conclusions

Plastic surgery hand trauma services have not yet fully recovered. Further interventions are required to aid recovery to pre-pandemic standards.