Hand Surgery in Singapore.

Singapore as an island nation is one of three countries in the world that has hand and reconstructive microsurgery (HRM) as an independent specialty. The 52 accredited hand surgeons serving a population of 5.7 million facilitate hassle free access to patients. Hand surgery historically is rooted very much in orthopaedic surgery as in most Asian countries with more than five decades of rapid evolution. Singapore pioneered a structured and systematic training program for HRM and the local surgeons have contributed significantly to the body of knowledge in hand surgery with targeted research and publications with three surgeons being awarded international recognition for their contributions. Singapore continues to contribute significantly to surgical volunteerism regionally through active involvement in the training of regional surgeons through their sustainable volunteer activities and through international fellowships in Singapore hospitals. The future of hand surgery in Singapore will be more competency and multidiscipline based on community-centered approach.

Managing hand and reconstructive microsurgery service during COVID-19 pandemic: Singapore experience.

INTRODUCTION: Managing healthcare service during pandemics and outbreaks is a challenging process. The aim is to keep patient safety as the priority, besides, continuing to provide essential healthcare services. METHODS: Situational audit was performed for the services rendered before and during COVID-19 pandemic and the elevation of the disease alert status, and a retrospective analysis of the attendance and procedures performed in the service. RESULTS: We present a methodology for performing a situational audit and generating service modification for hand and reconstructive microsurgery unit in a pandemic. There was no significant difference between the number of patients seen at outpatient clinics. However, there was a reduction in the numbers of total surgeries performed, with a 40% drop in the number of elective surgeries performed. There was also a reduction of cases seen in the emergency department hand clinic. DISCUSSION: COVID-19 pandemic is currently affecting not only the health service but also, other vital services all over the world. The pandemic puts significant challenges to acute surgical services in a hospital system involved in the management of the pandemic. Surgeons need to take proactive and a systematic approach in managing the available resources while maintaining essential surgical services. This paper provides the tools and methodology for doctors to plan their services in a pandemic situation. CONCLUSIONS: It is possible to maintain essential surgical services in a pandemic situation through rapid situational audits and generating localised strategies while considering the constraints imposed during the pandemics while maintaining patient and staff safety.