Comparing Complication Rates for Plastic Surgery Minor Procedure in Hospital and Out-of-Hospital Premises Clinics: A One Year Retrospective Review of 2739 Cases During COVID19 Pandemic.

Abstract

Purpose: This study compares complication rates for minor reconstructive procedures done under local anesthesia in a hospital setting versus out-of-hospital premises (OHP) setting during the COVID-19 pandemic. If it could be shown that minor plastic surgeries have similar, if not reduced, complication types and frequencies, this would provide a strong rationale for more procedures to be delegated to non-hospital office settings. Not only would complication rates be lower for patients, resulting in improved quality of life and health outcomes, but there would be increased efficiency for minor plastic surgery procedures, improved patient wait times, and reduced burden on hospital resources to allow for accommodation of more complex and major procedures that cannot be performed elsewhere. Methods: This is a retrospective medical record review of patients who underwent minor plastic surgery procedures at a community hospital and OHP settings. All procedures were performed by the same plastic surgeon. Minor plastic procedures were defined as day procedures performed with only local anesthesia. Procedures were completed with field sterility (eg, use of drapes and sterile gloves) but not room sterility. A total of 2739 charts (537 hospital charts and 2202 clinic charts) from January 2022 to December 2022, were reviewed with annotation of patient demographics, procedure type, procedure site, follow-up dates, complications, and complication type, if any. Statistical analysis involving chi-squared tests was performed on anonymized data to primarily compare complication rates between the hospital and the outpatient clinic setting, as well as secondary comparisons of subgroups such as patients with diabetes and patients using blood thinners. Results: There was a 3.5% complication rate for the minor procedures in the hospital compared to 1.2% in OHP setting which was a statistically significant finding. Conclusion: There were fewer complications for patients undergoing minor reconstructive procedures in an outpatient clinic setting versus in-hospital, indicating the potential for delegation of minor surgeries to OHP clinics and ambulatory surgery centers.