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COVID-19 and Skin Cancer: Restructuring Medical Service of UK Tertiary Center

By: Emily Rhode
Posted: Wednesday, July 27, 2022

An article published in JPRAS Open (the official journal of the British Association of Plastic, Reconstructive and Aesthetic Surgeons) highlighted the advantages of altered triage and management of non-melanoma skin cancer (NMSC) at the beginning of the COVID-19 pandemic. Omar Abbassi, MBBS, of the Addenbrooke’s Hospital, Cambridge, United Kingdom, and colleagues found that the necessary redeployment of plastic surgery trainees, staff, and resources due to the pandemic and subsequent restructuring of surgical services with an increase in consultant-led surgeries yielded beneficial changes in service for patients with NMSC.

“The consultant-led triage and excision framework manifested a higher rate of excisions positive for NMSC with a low rate of close and incomplete excisions,” stated Dr. Abbassi and colleagues.

The authors performed a retrospective analysis of patients who underwent skin excisions under local anesthetic that were determined by histopathologic analysis to be basal cell carcinoma or squamous cell carcinoma. Data from 168 patients treated between February 2020 and the end of May 2020 were compared with data from 65 patients during the same period in 2019. In addition to patient demographics and diagnosis, the researchers looked at deep and peripheral margins, incomplete excisions, and altered management decisions due to pandemic-related restrictions.

Findings revealed a 158% increase in excised lesions confirmed by histopathologic analysis as NMSC during the pandemic period. There were fewer close margin excisions in 2020 than in 2019 (27.7% vs. 17.8%; P = .096). The 2020 cohort also had a lower number of involved margin excisions compared with 2019 (3.1% vs. 1.8%; P = .62). The number of excisions performed by consultants was higher in 2020 than in 2019 (42.9% vs. 21.5%).

In addition, the cancellation of nonurgent and benign surgeries increased the capacity for cancer surgery, and consultant-led surgeries increased patient flow. Based on these findings, the authors concluded that further examination of this model is needed as nonurgent and benign elective surgeries return to normal levels.

Disclosure: The authors reported no conflicts of interest.

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