Management and Clinical Aspects of Burned Patients Affected by SARS-COV2

At the end of January 2020, SARS-CoV-2 started escalating worldwide. COVID-19 can exert its effects on immunity, inflammation, and multi-organ system disease, common denominators with the burn injury. The pandemic required major efforts to Burn centres in order to preserve burn patients’ care and contribute to the health care response. In our Burn Unit we autonomously developed a protocol for patients acceptance and surveillance of the hospitalized ones and the personnel. We briefly describe our experience with six cases of burn patients infected by SARS-CoV-2 highlighting the overlap between medical treatment of burn patients and COVID-19 patients. To avoid viral spreading epidemiologic control is essential, especially preventive measures such as isolation of infected patients and identification of the source of infection. In our surgical practice, we increased the use of enzymatic debridement avoiding procedures with a high risk of viral particles spreading. Personnel protection and dedicated pathways have been planned, optimizing air circulation and disinfection. Vaccines represent the best hope for the global population to stop the viral spread, despite new variants outbreaks

Litigation Cases After Post-Bariatric Surgery: Lesson from the Past

Background Due to the high demand of post-bariatric surgeries, the number of litigation cases is rapidly growing. Even if surgical mistakes still represent one of the main causes of medico-legal issues, many disputes depend on what happens in the post-operative course. In this article we analyzed the litigation cases that occurred in our Plastic Surgery Department, the current literature about medico-legal disputes and the importance of the doctor-patient relationship. Patients and methods The medical records of 788 post-bariatric surgeries, the post-operative complications and the related litigation cases from January 2015 to December 2019 were collected, analyzed and compared. Results We performed 380 abdominoplasties, 28 torsoplasties, 65 breast reductions, 99 mastopexies, 94 brachioplasties, 52 thighplasties, 65 liposuctions and 5 facelifts between 2015 and 2019. Eight patients complained of medical issues and claimed for litigation. Despite in all cases the judges highlighted the risk of consent misinterpretation, the payout was granted only in one case. Conclusion Post-bariatric patients often mistake their preoperative condition and consider body contouring procedures as an aesthetic surgery treatment. Patients should be therefore clearly informed about the complexity of body contouring procedures after massive weight loss, which should never be compared to aesthetic surgery. Surgeons should always promote the communication with their patients and build a strong and trustworthy relationship. This attitude will allow to deal more easily with complications and, in the worst situations, with medico-legal litigations