How SARS-CoV-2 has Changed the Activities in a Regional Hand Surgery Centre in Italy

Since the start of the SARS-CoV-2 pandemic,[1] our lives have changed completely. In Italy, since the ninth of March we have been on “lockdown.”[2] This has affected every part of our society, from normal daily life to the closure of so much of our industry; of course, it has hugely impacted the ways in which we provide our health care.

Many Italian hospitals have changed their normal working patterns to treat COVID-19 positive patients. Our institution has converted two of our three main hospitals to help with the emergency response, and in doing so, it has provided 31 intensive therapy unit (ITU) beds and 161 high-dependency unit (HDU) beds.

We have created a “clean” route for non-COVID patients and a COVID-19 positive route in an attempt to protect the unaffected patients and healthcare professionals involved in their care.

As with many of the countries affected, the need for doctors and nurses has risen dramatically in the fight against the SARS-CoV-2 pandemic; for this reason, two thirds of our fellow colleagues in our unit have been relocated to COVID positive ITUs and HDUs to help anesthesiologists, pneumologists, internists, and all the other doctors involved in the response.

Our unit has stopped all nonurgent consultations and elective surgeries, thus diverting all our forces to the management of acute trauma. To keep our patients safe, we have established a new way of streamlining referrals. Every patient who needs urgent care for his or her upper limb is being accepted from our A&E electronically and sent to our non-COVID hospital. Once in the hospital, the patients follow a strict algorithm of care. This not only assures a safe way for patients to be treated but also maintains the safety of healthcare professionals.

The trauma workload has changed dramatically, and we have noticed a significant decrease in the number of cases; however, many of those still occurring are amputations and DIY-related injuries. We have also restructured our physiotherapist workload. Some of our team members are continuing to provide therapy to patients who have suffered injuries in this time, while the remaining therapists have been dispatched to the COVID positive units to guarantee mobilization and physiotherapy to patients in the ITUs and HDUs. Some of our team members have also started to produce a prone helmet support for polyurethane devices used in ITUs during patients’ pronation.

Our teaching has also been forced to adapt. We have organized regular teaching sessions in various fields of plastic, reconstructive, and hand surgery using the platform ZOOM (©2020 Zoom Video Communications, Inc.). We have successful provided lessons to our juniors, fellow colleagues and physiotherapists, and have scheduled lessons with professors from other departments and universities, thus ensuring best possible education to our trainees and colleagues during this difficult time.

The SARS-COV-2 pandemic has given and continues to throw unforeseeable challenges; however, it has also given us the strength to continue to provide high-quality care and education. Everyone has to play a key role in the battle: doctors, nurses, therapists, and certainly society.

Finally, we want to thank the healthcare professionals all around the world for keeping up the fight against the virus by saving lives everyday while sacrificing theirs.

Publication History

Article published online:
02 May 2020

• References

• 1 World Health Organization. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed March 16, 2020
• 2 Italian Government Presidency of the Council of Ministers. Available at: http://www.governo.it/it/articolo/rmato-il-dpcm-9-marzo-2020/14276. Accessed March 16, 2020