Impact of COVID-19 on hand surgery in Italy: A comparison between the Northern and the Southern regions

F Toia; M Romeo; M Abate; E Avarotti; B Battiston; G Bruno; F Cannavò F; C Casamichele; M Colonna; N Catena; M Cherubino; S Coppolino; N Galvano; G Giuca; S Gullo; G Internullo; A Lazzerini; I Marcoccio; M Maruccia; C Melloni; G Pajardi; P Pugliese; G Risitano; G Spata; M Tripoli; L Troisi; P Tos; A Cordova

doi:10.1016/j.hansur.2020.11.005

Impact of COVID-19 on hand surgery in Italy: A comparison between the Northern and the Southern regions

Hand Surg Rehabil. 2021 Apr;40(2):139-144. doi: 10.1016/j.hansur.2020.11.005. Epub 2020 Dec 10.

Authors

F Toia¹, M Romeo², M Abate³, E Avarotti⁴, B Battiston⁵, G Bruno⁶, F Cannavò F⁷, C Casamichele⁸, M Colonna⁹, N Catena¹⁰, M Cherubino¹¹, S Coppolino¹², N Galvano¹³, G Giuca¹⁴, S Gullo¹⁵, G Internullo¹⁶, A Lazzerini¹⁷, I Marcoccio¹⁸, M Maruccia¹⁹, C Melloni²⁰, G Pajardi²¹, P Pugliese², G Risitano²², G Spata²³, M Tripoli², L Troisi²¹, P Tos²⁴, A Cordova²

Affiliations

¹ Plastic and Reconstructive Surgery, Department of Surgical Oncological and Oral Sciences, University of Palermo, Via Del Vespro 127, 90127, Palermo (PA), Italy. Electronic address: francesca.toia@unipa.it.
² Plastic and Reconstructive Surgery, Department of Surgical Oncological and Oral Sciences, University of Palermo, Via Del Vespro 127, 90127, Palermo (PA), Italy.
³ SSD di Ortopedia, ARNAS Garibaldi, Presidio di Nesima, Via Palermo 636, 95123, Catania (CT), Italy.
⁴ Department of Orthopedics and Traumatology, A.R.N.A.S. Piazza Santa Maria di Gesù 5, 95124, Catania (CT), Italy.
⁵ Department of Orthopedics and Traumatology, Orthopedic and Trauma Center, AOU Città della Salute e della Scienza, Via Nizza 138, 10126, Torino (TO), Italy.
⁶ Department of Orthopedics and Traumatology, A.O. Vittorio Emanuele, Via Plebiscito 632, 95122, Catania (CT), Italy.
⁷ U.O.S.D. Plastic Surgery A.O. Papardo, Contrada Papardo, 98158, Messina (ME), Italy.
⁸ Department of Orthopedics and Traumatology, A.O. "G. Paolo II", Contrada Cisternazzi, 97010, Ragusa (RG), Italy.
⁹ Plastic Surgery Unit, Department of Human Pathology, University of Messina, Via Consolare Valeria1, 98124, Messina (ME), Italy.
¹⁰ Pediatric Orthopedic and Traumatology Unit, Children's Hospital, AON SS Antonio e Biagio e Cesare Arrigo, Via Spalto Marengo 46, 15121, Alessandria (AL), Italy.
¹¹ Department of Biotechnology and Life Sciences, Division of Plastic and Reconstructive Surgery, University of Insubria, Via Ravasi 2, 21100, Varese (VA), Italy.
¹² Hospital S. Vincenzo, Contrada Sirina, 98039, Taormina (ME), Italy.
¹³ Department of Orthopedics and Traumatology A.O.U.P." Paolo Giaccone", Via Del Vespro 127, 90127 Palermo (PA), Italy.
¹⁴ Department of Orthopedics Ospedale Maggiore, Via Resistenza Partigiana, 97015, Modica (RG), Italy.
¹⁵ Department of Hand Surgery and Traumatology, A.R.N.A.S., Piazza Nicola Leotta 4, 90127, Palermo (PA), Italy.
¹⁶ Department of Orthopedics, Ospedale Gravina, Via Portosalvo 9, 95041, Caltagirone (CT), Italy.
¹⁷ Hand Surgery and Microsurgery Unit, IRCCS Humanitas Clinical Institute, Via Alessandro Manzoni 6, 20089, Milano (MI), Italy.
¹⁸ Orthopedic Microsurgery and Upper Limb Surgery, Istituto Clinico Città di Brescia, Via Bartolomeo Gualla 15, 25128, Brescia (BS), Italy.
¹⁹ Department of Emergency and Organ Transplantation, Plastic and Reconstructive Surgery and Burns Unit, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70122, Bari (BR), Italy.
²⁰ Plastic and Reconstructive Surgery A.O. P. Borsellino, Contrada Cardilla 1, 91025, Marsala (TP), Italy.
²¹ Department of Clinical Sciences and Community Health, The University of Milan, Via Festa del Perdono 7, 20122, Milano (MI), Italy.
²² ABC Medical, Via Porto Salvo 2, 98121, Messina (ME), Italy.
²³ Hand Surgery, Polyclinic Morgagni, Via del Bosco 105, 95030, Catania (CT), Italy.
²⁴ Hand Surgery and Reconstructive Microsurgery Unit, Orthopedic Institute G. Pini-CTO, Piazza Cardinale Andrea Ferrari 1, 20122, Milano (MI), Italy.

Abstract
in English, French

The aims of this study were to evaluate the impact of the COVID-19 pandemic on emergency and elective hand surgery in four Italian regions that had either a high (Lombardy and Piemonte) or a low (Sicilia and Puglia) COVID-19 case load to discuss problems and to elaborate strategies to improve treatment pathways. A panel of hand surgeons from these different regions compared and discussed data from the centers they work in. The COVID-19 pandemic had an enormous impact on both elective and emergency surgery in Italy, not only in highly affected regions but also - and paradoxically even at a higher extent - in regions with a low COVID-19 case load. A durable and flexible redesign of hand surgery activities should be promoted, while changing and hopefully increasing human resources and enhancing administrative support. Telematics must also be implemented, especially for delivering rehabilitation therapy.

Les objectifs de cette étude étaient d'évaluer l'impact de la pandémie de COVID-19 sur la chirurgie d'urgence et élective de la main dans 4 régions italiennes avec un impact COVID-19 élevé (Lombardie et Piémont) ou faible (Sicile et Pouilles), pour discuter des problèmes et élaborer des stratégies pour améliorer les voies thérapeutiques. Un panel de chirurgiens de la main des différentes régions a comparé et discuté les données des centres dans lesquels ils travaillent. La pandémie de COVID-19 a eu un énorme impact sur la chirurgie élective et d'urgence en Italie, non seulement dans les régions fortement touchées mais aussi – et paradoxalement même à un degré plus élevé – dans les régions à faible charge de cas de COVID-19. Il faudrait promouvoir un remodelage durable et flexible des activités de chirurgie de la main, avec un changement dans la gestion des ressources humaines et, espérons-le, une augmentation des ressources humaines et un soutien administratif plus élevé. Un soutien télématique devrait également être mis en place, notamment pour dispenser la rééducation.

Keywords: COVID-19; Chirurgie d'urgence de la main; Chirurgie de la main; Chirurgie élective de la main; Elective hand surgery; Emergency hand surgery; Hand surgery.

Publication types

Comparative Study

MeSH terms

COVID-19 / epidemiology*
COVID-19 Testing / statistics & numerical data
Elective Surgical Procedures / statistics & numerical data
Hand / surgery*
Health Services Accessibility / statistics & numerical data
Humans
Italy / epidemiology
Orthopedic Procedures / statistics & numerical data*
Pandemics*
Personnel Staffing and Scheduling / organization & administration
Physical Therapy Modalities / organization & administration
Physical Therapy Modalities / statistics & numerical data
Postoperative Care
Surveys and Questionnaires
Telemedicine / statistics & numerical data

Abstract in English, French

Publication types

MeSH terms

Abstract
in English, French