Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Feb 2021
Short-term outcomes after Ivor Lewis oesophagectomy for cancer during the COVID-19 pandemic.
Elective surgery in the UK came to a halt during the early part of the COVID-19 pandemic. As COVID-19-related infection and mortality rates in Devon and Cornwall were relatively low, however, urgent elective surgery continued in Plymouth, with the necessary precautions in place. This study aimed to assess outcomes following Ivor Lewis oesophagectomy (ILO) during the pandemic. ⋯ ILO can be performed safely during the COVID-19 pandemic with the necessary precautions in place.
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Ann R Coll Surg Engl · Feb 2021
Safe surgical tracheostomy in patients with COVID-19: key clinical considerations.
Surgical tracheostomy is a high aerosol-generating procedure that is an essential aid to the recovery of patients who are critically ill with COVID-19 pneumonia. We present a single-centre case series of 16 patients with COVID-19 pneumonia who underwent tracheostomy. We recommend that the patient selection criteria for achieving a favourable outcome should be based on fraction of inspired oxygen together with prone-position ventilation. ⋯ Timely tracheostomy also leads to an earlier freeing up of ventilator space during a period of a rapidly escalating pandemic. The outcomes in terms of swallow and speech function were also assessed. The study has also helped to remove the anxiety around open a tracheostomy in patients who are COVID-19 positive.
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Ann R Coll Surg Engl · Feb 2021
Observational StudyThe effect of the COVID-19 pandemic on mental health associated trauma, admissions and fractures at a London major trauma centre.
Non-injury-related factors have been extensively studied in major trauma and have been shown to have a significant impact on patient outcomes. Mental illness and associated medication use has been proven to have a negative effect on bone health and fracture healing. ⋯ While total numbers using the orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affects those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. It is imperative that adequate support is in place for patients with vulnerable mental health during these periods, particularly as we look towards a potential 'second wave' of COVID-19.