Singapore's experience in managing the COVID-19 pandemic: Key lessons from the ground.

Singapore managed the COVID-19 pandemic in the past three years and gleaned valuable lessons on patient management when the public healthcare system was inundated with COVID-19 patients. There were several initiatives, which included setting up of community treatment facilities to help hospitals manage in-patient loads that did not require acute monitoring, leveraging telemedicine, and developing heuristics to sort patients based on their clinical disposition to various care pathways and to effectively manage patients of different medical needs. These initiatives were implemented in the second year of the epidemic in 2021 and did not include the dormitory-based migrant workers and migrant workers in the construction, maritime and production sectors who were under the care of the Assurance, Care and Engagement Group (ACE) in the Ministry of Manpower that had its own set of treatment management measures.

The role of multiplatform messaging applications in burns care and rehabilitation: A systematic review.

Background: Multiplatform messaging applications also referred to as cross-platform instant messaging play an important role in delivery of healthcare and education with its low cost, ease of use and accessibility.

Aim: To evaluate the existing evidence regarding the use of multiplatform messaging applications in facilitating consultations and decision-making processes in the context of burns care, as well as to assess the impact of such applications on burns care and rehabilitation.

Method: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PROSPERO protocol CRD42021265203.

Achieving self-sufficiency in skin allograft: A Singapore experience.

Aim: This paper describes how Singapore achieved skin allograft self-sufficiency in 2017 by adopting 5 key strategies in 2012.

Background: Singapore General Hospital (SGH) established its own allograft recovery programme in 1998 but was still dependent on overseas allograft procurement.

Key Strategies: RESULTS: The allograft recovery programme expanded from 4 to all 20 institutions.

The Telemedicine Demand Index and its Utility in Managing COVID-19 Case Surges.

Telemedicine was an integral component in Singapore's COVID-19 management strategy, having been deployed at a national level in a centrally-administered program whereby patients at higher risk of developing severe COVID-19 disease were proactively assigned tele-consultations, whereas those at lower risk and seen by primary care physicians could request tele-consultations. To better plan for fluctuations in telemedicine demand during the pandemic, the Telemedicine Demand Index (TDI) was developed. Three main factors influencing telemedicine demand were considered-characteristics of the Variant of Concern, prevailing health care policies, and the population's healthcare-seeking behaviour-from which 11 coefficients were derived for the TDI formula.

Assessment of COVID-19 Positive Rates Amongst COVID-19 Close Contacts Through the Health Risk Warning System.

From 6 Jan 22 to 17 Feb 22, a total of 729,367 close contacts classified into four distinct groups (i.e., household, social, school and nursing/ welfare home contacts) were managed by the Health Risk Warning system.

COVID-19 Close Contact Management: An Evolution of Operations Harnessing the Digital Edge.

Singapore, like many other nations globally, had to contend with significant caseloads arising from the Coronavirus disease (COVID-19) pandemic. This paper focuses on using technology as an intervention for pandemic management. With scant scientific evidence on effective medications and vaccinations (i.

Enhanced Monitoring System to Better Monitor High-Risk COVID-19 Patients.

Telemedicine (TM) is a useful tool to extend medical care during a pandemic. TM was extensively utilized in Singapore during the COVID-19 pandemic as part of the Nation's COVID-19 healthcare strategy. Patients were risk stratified to prioritize limited healthcare resources and the Telemedicine Allocation Reconciliation System (TMARS) was adapted to monitor and manage limited TM resources.

Applicability and benefits of telemedicine in the monitoring of monkeypox close contacts.

Monkeypox is a zoonotic disease caused by the monkeypox virus and classically presents as a vesicular rash accompanied by fever and lymphadenopathy. Singapore reported the first imported case of monkeypox infection on 21 June 2022, the first local unlinked case on 6 July 2022, and the first local linked case on 5 August 2022. Telemedicine was used in the management of monkeypox close contacts to (1) screen for the development of signs and symptoms consistent with monkeypox infection, (2) assess for successful post-exposure prophylaxis via direct visualisation of vaccination site morphological progression, (3) detect serious reactions arising from post-exposure prophylaxis administration, and (4) evaluate for deterioration in mental health status during the 21-day quarantine period.

Nationwide implementation of a centralised telemedicine platform in Singapore to fight the COVID-19 pandemic.

Introduction: This study aims to share the experience of the Ministry of Health (Singapore) in deploying a centrally managed Telemedicine service to triage, and manage COVID-19 cases in the community during the COVID-19 Omicron wave.

Material And Methods: Data from the deployed telemedicine system, Telemedicine Allocation and Reconciliation System, over a 14-week period (3 January 2022-10 April 2022) was analysed to determine the safety and efficacy of both the (i) National COVID-19 sorting logic algorithm and (ii) the use of a centralised telemedicine platform with privacy protection in a pandemic.

Results: There was a total of 47,754 children (aged 1-11 years old), 75,702 adolescents and adult patients (aged 12-69 years old) and 55,774 geriatric patients (aged > = 70 years old) who were directly managed by this platform.

A prospective comparative study on the effectiveness of two different non-adherent polyurethane dressings on split-thickness skin graft donor sites.

Aim: To analyze differences in re-epithelization, exudate absorbency, ease and pain on dressing removal between ALLEVYN™ Non-Adhesive and Betaplast™ N.

Methodology: Patients admitted to the general ward undergoing split skin grafting were recruited. Allevyn and Betaplast were applied on the donor site.

A simple mnemonic, B.U.R.N.S., for burns first aid.

Introduction: Burn injuries remain common in the world, with an average of more than thousands of cases requiring medical attention each year. Singapore sees an average of 220 burns admissions annually. Given the high number of burn cases in Singapore, the authors identified that there is a need for more public awareness on first aid burn treatment.

Keratin-Alginate Sponges Support Healing of Partial-Thickness Burns.

Deep partial-thickness burns damage most of the dermis and can cause severe pain, scarring, and mortality if left untreated. This study serves to evaluate the effectiveness of crosslinked keratin-alginate composite sponges as dermal substitutes for deep partial-thickness burns. Crosslinked keratin-alginate sponges were tested for the ability to support human dermal fibroblasts in vitro and to support the closure and healing of partial-thickness burn wounds in pigs.

A Review of Skin Banking Guidelines and Standards Worldwide: Towards the Harmonization of Guidelines for Skin Banking in Therapeutic Applications for the Regions under the Asia Pacific Burn Association (APBA).

Currently, there are no harmonized guidelines which govern skin banking in the Asia Pacific region. Therefore, skin banks are either unregulated or rely on their nation's legislation or international accreditation to uphold their quality standards. A new set of skin banking guidelines was developed through a comprehensive review and collation of best international practices for the Asia Pacific Burn Association (APBA) members, from donor screening and testing, to skin recovery, processing, storage and distribution, and quality assurance.

Burn center function during the COVID-19 pandemic: An international multi-center report of strategy and experience.

The novel coronavirus, SARS-CO V2 responsible for COVID-19 pandemic is rapidly escalating across the globe. Burn centers gearing for the pandemic must strike a balance between contributing to the pandemic response and preserving ongoing burn care in a safe and ethical fashion. The authors of the present communication represent seven burn centers from China, Singapore, Japan, Italy, Spain, the United Kingdom (UK), and the United States (US).

Connexin 43 upregulation in burns promotes burn conversion through spread of apoptotic death signals.

Background: Burn wounds continue to worsen after initial injury in a process known as burn conversion, which lasts about 3-5 days. It causes burn wounds to enlarge and deepen, leading to greater morbidity. Apoptosis is one of the factors contributing to the conversion of the zone of stasis into the zone of coagulation.

Multifunctional Antimicrobial Nanofiber Dressings Containing ε-Polylysine for the Eradication of Bacterial Bioburden and Promotion of Wound Healing in Critically Colonized Wounds.

Bacterial colonization of acute and chronic wounds is often associated with delayed wound healing and prolonged hospitalization. The rise of multi-drug resistant bacteria and the poor biocompatibility of topical antimicrobials warrant safe and effective antimicrobials. Antimicrobial agents that target microbial membranes without interfering with the mammalian cell proliferation and migration hold great promise in the treatment of traumatic wounds.

Renal outcomes of intensive care burn patients in an Asian tertiary centre.

Introduction: Acute kidney injury (AKI) is a frequent complication of severe burn injury and is associated with a high mortality rate of up to 80%. We aimed to establish the incidence, mortality rate, and factors related to mortality in adult patients with severe burn injury and AKI with renal replacement therapy (RRT) in Singapore.

Methods: We performed a retrospective cohort study of severely burned patients who were admitted to the Burns Intensive Care Unit (BICU) at the Singapore General Hospital (SGH) from January 2008 to December 2016.

Airway management in inhalation injury: a case series.

Inhalation injury is a serious consequence of a fire or an explosion, with potential airway compromise and respiratory complications. We present a case series of five patients with inhalational burns who presented to Singapore General Hospital and discuss our approach to their early management, including early evaluation and planning for the upper and lower airway, coexisting cutaneous burns, and monitoring their ICU (intensive care unit) severity of illness, sepsis and acute respiratory distress syndrome. All five patients suffered various grades of inhalation injury.

The diathermy scratch pad: A cheap and efficient tool for chemical and explosion-related burns.

The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns.

Photographic evaluation of different adrenaline-containing tumescent solutions on skin graft donor site bleeding: A prospective randomised trial.

Background: Tumescent infiltration is a technique to reduce skin graft donor site bleeding, however there are no studies comparing tumescent solutions with different concentrations of adrenaline on donor site blood loss. We sought to evaluate the effect on skin donor site bleeding of different adrenaline concentrations in adrenaline-containing tumescent solutions in a prospective randomised trial.

Methods: Donor sites were marked into thirds and each segment randomised to receive tumescent infiltration containing no adrenaline, adrenaline 1:500,000, or adrenaline 1:250,000.