St Andrew's ambulatory care strategy for animal & human bite injuries & localised infections.

Background: Infected animal bites and localised infections are traditionally managed by inpatient admission, intravenous antibiotics, and localised washout +/- debridement. Our hand trauma protocol was modified to accommodate the challenges faced in delivering this pathway during the COVID-19 pandemic.

Objective: To evaluate the outcomes of two management pathways, ambulatory (2020) vs inpatient (2019), at a single tertiary referral centre.

Unilateral breast reconstruction using double transverse upper gracilis (TUG) flaps.

Introduction: When the deep inferior epigastric perforator (DIEP) flap is unavailable, autologous reconstruction of a moderate-to-large breast presents a surgical challenge. We retrospectively review our experience of unilateral breast reconstruction using double transverse upper gracilis (TUG) flaps and highlight specific technical considerations.

Methods: Thirty-four patients underwent double TUG flaps for unilateral breast reconstruction between 2012 and 2020.

St Andrew's COVID-19 Surgery Safety (StACS) study: Skin cancer.

Background: Skin cancer represents the most common malignancy worldwide and it is imperative that we develop strategies to ensure safe and sustained delivery of cancer care which are resilient to the ongoing impact of COVID-19.

Objective: This study prospectively evaluates the COVID-19 related patient risk and skin cancer management at a single tertiary referral centre, which rapidly implemented national COVID-19 safety guidelines.

Method: A prospective cohort study was performed in all patients who underwent surgery for elective skin cancer service management, during the UK COVID-19 pandemic peak (April-May 2020).

St Andrew's COVID-19 surgery safety (StACS) study: The Burns Centre experience.

Background: The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has the potential to significantly impact burns patients both directly through infective complications of an immunocompromised cohort, and indirectly through disruption of care pathways and resource limitations. The pandemic presents new challenges that must be overcome to maintain patient safety; in particular, the potential increased risks of surgical intervention, anaesthesia and ventilation. This study comprehensively reviews the measures implemented to adapt referral pathways and mitigate the risk posed by COVID-19 during the height of the pandemic, within a large Burns Centre.