The Journal of hand surgery
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The case spectrum in hand surgery is one of extremes-purely elective day surgery cases under local anesthesia to mangling limb injuries that require immediate, and frequently, lengthy, surgery. Despite the cancellation of most elective orthopedic and plastic surgical procedures, hand surgeons around the world continue to see a steady stream of limb-threatening cases such as severe trauma and infections that require emergent surgical care. With the increase in community-spread, an increasing number of COVID-19-infected patients may be asymptomatic or have mild, nonspecific or atypical symptoms. ⋯ General guidelines for perioperative care of the COVID-19-positive patient have been published. However, our practices differ from those of general orthopedic and plastic surgery, primarily because of the focus on trauma. This article discusses the perioperative and technical considerations that are essential to manage the COVID-19 patient requiring emergency care, without compromising clinical outcomes and while ensuring the safety of the attending staff.
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Our purpose was to evaluate the implementation of a postoperative hand and upper extremity telemedicine program. We aimed to compare travel burden, visit time, and patient satisfaction between an initial postoperative telemedicine visit and a second conventional in-clinic visit. ⋯ Telemedicine after hand and upper extremity surgery results in high levels of patient satisfaction and decreases visit times and the travel burdens associated with conventional in-clinic appointments.