Hand Injuries in the State of Florida, Are Centers of Excellence Needed?
- 1 June 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of Trauma and Acute Care Surgery
- Vol. 68 (6), 1480-1490
- https://doi.org/10.1097/ta.0b013e3181bb8c70
Abstract
Hand injuries are common and costly. The need for hand surgery specialists is undeniable. In the state of Florida, the availability of specialty services in hand surgery is limited. Florida ranks 4th in population and 32nd in hand surgeons per 100,000 state residents. Recent media reports highlight these limitations among hand surgeons and other specialists in the state. To evaluate the need for hand surgery centers of excellence in the state, we performed a retrospective review of data collected from the Agency for Health Care Administration database of hospital inpatient admissions from 1997 to the second quarter of 2007. Demographic information, details of the injury, and outcome data were evaluated in patients with amputation injuries. Amputations of the thumb, fingers, and hand/wrist/forearm were counted and factors associated with these injuries were recorded. Place of occurrence and injuries caused by machinery were evaluated. A regression analysis was performed to evaluate trends in the number of amputations and replantation procedures. We identified 4,858 patients with amputations in this time period. There were ∼462 amputations per year. The trend in finger amputations appeared to be increasing yearly, whereas the trend for replantation surgery was decreasing. Six percent of the hospitals recording admissions with the Agency for Health Care Administration performed 68% of the replantation surgeries in the state. We also noted an increasing proportion of patients being admitted and treated outside of their own county and region. With fewer replantation surgeries performed and patients traveling farther for treatment we conclude that there is a need for coordinated evaluation, triage and treatment of patients with hand injuries requiring specialized hand surgery services at centers of excellence in Florida.Keywords
This publication has 20 references indexed in Scilit:
- Replantation of Thumb Avulsion InjuriesHandchirurgie · Mikrochirurgie · Plastische Chirurgie, 2007
- Digital ReplantationHand Clinics, 2007
- A Retrospective Study of Functional Outcomes After Successful Replantation Versus Amputation Closure for Single Fingertip AmputationsThe Journal of Hand Surgery, 2006
- INDICATIONS AND SELECTION FOR DIGITAL AMPUTATION AND REPLANTATIONJournal of Hand Surgery (European Volume), 2001
- Replantation–Revascularization and Primary Amputation in Major Hand InjuriesJournal of Hand Surgery (European Volume), 1996
- The social and economic consequences of finger amputationsActa Orthopaedica, 1994
- Thumb Replantation: Survival Factors and Re-Exploration in 122 CasesJournal of Hand Surgery (European Volume), 1993
- To trim or replant: A matter of costWorld Journal of Surgery, 1991
- Thumb Replantation or Not?Scandinavian Journal of Plastic and Reconstructive Surgery, 1986
- The Need for Replantation Surgery after Traumatic Amputations of the Upper Extremity—An Estimate Based upon the Epidemiology of SwedenJournal of Hand Surgery (European Volume), 1984