Resumption of Short-term Burn Reconstruction Missions to Ukraine in Light of COVID-19: A Paradigm Shift

Author:

Dabek Robert J1ORCID,Vlasov Alexey2,Savenko Maxim3,Pasunko Artem4,Driscoll Daniel N5,Knittel Justin G6,Fuzaylov Gennadiy7

Affiliation:

1. Department of General Surgery, Ascension Saint Agnes Hospital , Baltimore, MD, USA

2. Regional Children’s Hospital , Dnipro , Ukraine

3. Department of Pediatric Surgery, Dnipro State Medical School , Dnipro , Ukraine

4. Department of General Surgery, Regional Children’s Hospital , Dnipro , Ukraine

5. Department of Surgery, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA

6. Department of Anesthesiology, Washington University School of Medicine , St Louis, MO, USA

7. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA

Abstract

Abstract The COVID-19 pandemic has disrupted the lives of billions of people globally. Some medical systems continue to be overburdened due to the viral illness leading to incredible public health challenges domestically as well as abroad. However, with vaccination distribution increasing globally, many are pushing for a return to some form of normalcy. In the medical community, some are weighing the risks of returning to global health missions and considering protective strategies to minimize risk of viral spread. Here, we describe our experience in returning to an annual burn reconstruction mission in a low- and middle-income country. We have successfully carried out a return surgical mission trip. Our team of 10 individuals was able to perform over 75 procedures on 25 pediatric patients in 4 operative days. We applied a variety of protective strategies and altered mission protocol to limit exposure and transmission risk while focusing heavily on education and training. Additionally, we increased the use of telemedicine and eliminated typical in-person clinic visits. We increased operative complexity to increase impact while limiting patient exposure. Rigorous perioperative safety and follow-up protocols were implemented. The increased use of telemedicine, reduction of in-person visits, emphasis on education, and implementation of safety and follow-up protocols have led to an improvement in efficiency, safety, and accountability. Our adaptations have provided guidance on responsibly resuming surgical outreach missions, with changes that are likely to endure beyond the COVID-19 pandemic.

Publisher

Oxford University Press (OUP)

Subject

Rehabilitation,Emergency Medicine,Surgery

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