Background: Children are less susceptible to infection with SARS-CoV-2 and subsequent severe disease, yet especially vulnerable to the indirect effects of the pandemic. A constrained healthcare service, combined with the societal and behavioural changes observed during the pandemic, is likely to have altered the presentation of paediatric surgical disease. The objective was to investigate the impact of the COVID-19 pandemic on the volume of paediatric surgical admissions, the severity of disease and the type of surgical pathology treated at our centre.
Methods: A retrospective cohort study compared paediatric surgical admissions in an eleven-month period before COVID-19 to the same period during the pandemic. Comparisons in volume and diagnoses were based on the number of admissions. Predetermined criteria for severity of disease using triage scores, intraoperative findings and intensive care admissions were compared.
Results: A total of 1 810 admissions were recorded, 1061 in the pre-COVID group and 749 during COVID. Emergency admissions reduced by 9.2%, most notably due to a reduction in trauma, caustic ingestions and constipation. There was an increase in incarcerated inguinal hernias and helminth-related pathologies. Significantly more intussusceptions failed pneumatic reduction requiring surgical intervention with bowel resection. There was a two-fold increase in patients requiring emergency intensive care.
Conclusion: Paediatric surgical volumes at our centre decreased during the COVID-19 pandemic. There was evidence of more advanced disease on presentation of inguinal hernias and intussusception and a generalised increased demand for emergency ICU admission.
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http://dx.doi.org/10.36303/SAJS.4060 | DOI Listing |
N Am Spine Soc J
December 2024
Department of Orthopaedic Surgery, SSM Health Saint Louis University Hospital, Saint Louis, MO 63110, United States.
Background: Pediatric spinal deformity surgery affects ultimate spinal height in the growing child. This effect on ultimate spinal height has also been shown to affect pulmonary development and ultimately pulmonary function. There has been an increasing trend toward growth-friendly spinal surgery in early onset scoliosis to minimize the negative consequences of early spinal fusion surgery.
View Article and Find Full Text PDFInt J Burns Trauma
December 2024
School of Medicine, Islamic Azad University, Najafabad Branch Isfahan, Iran.
The management of complex burn injuries has evolved significantly, with various surgical techniques developed to improve outcomes. This review examines the evolution of these methods, focusing particularly on mesh grafting and the Meek technique. While mesh grafting is effective, it poses challenges such as limited graft coverage and a high demand for autologous skin.
View Article and Find Full Text PDFPain Res Manag
January 2025
Australian Research Centre for Population Oral Health, Adelaide Dental School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
General anaesthesia (GA) as a pharmacological behaviour management strategy may be indicated for dental extractions in children unable to cooperate in the dental chair. Pain is the most common postoperative complication in children following dental GA. There is conflicting evidence available on the efficacy of local anaesthetic (LA) agents for postoperative pain management following dental extraction.
View Article and Find Full Text PDFFront Surg
January 2025
Service de Chirurgie Orthopédique et Traumatologique, Cliniques Universitaires Saint-Luc, Bruxelles, Belgique.
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View Article and Find Full Text PDFCureus
December 2024
Pediatric Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, USA.
Subcutaneous emphysema results from air or gas being forced into the fascial spaces of subcutaneous tissue. Once the air or gas has entered the fascial spaces, it travels along connective tissue causing a mass effect and swelling. This rare complication usually presents with mild severity during the immediate postoperative period following surgical procedures of the head or neck regions and self-resolves with conservative treatment.
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