Did COVID outbreak influence our management of skin tumors?

Aim: COVID pandemic forced new medical protocols. COVID precautions also changed surgical algorithms causing a change in medical costs. This study aims to clarify COVID-era medical costs and underlying reasons for patients with Head & Neck (H&N) area skin tumors. Materials and Methods: Patients which were operated for H&N tumors in our clinic before and during the COVID outbreak were retrospectively analyzed per sex, age, etiology, PPE usage, treatments, and total costs. Statistical analysis was done for any significant changes. Results: A total of 127 patients of which 70 were operated before (G1) and 57 were operated after (G2) the COVID out-break for H&N tumors were evaluated. Mean ages were 69,94 years for G1 and 65,56 for G2. 28 BCC and 42 SCC patients were in G1 and 11 BCC and 46 SCC patients were in G2. In G1, 69 wide excisions, 44 skin graft, 17 skin flaps, 6 lymph node dissections (LNDs) were done. In G2, 56 wide excisions, 30 skin grafts, 9 skin flaps, 6 LNDs, 5 free flaps were done. G1 patients were hospitalized for a median of 2 days, while G2 patients were hospitalized for a median of 3 days. Median costs were 261,42inG1and261,42inG1and624.84 in G2. Statistical analysis with Mann-Whitney-U and Chi-Square tests revealed significant difference only between the costs. When disposable PPE was excluded, the median cost of G2 became $539.84 (G3). Statistical difference between G1 and G3 was found to be insignificant. Conclusion: COVID changed the etiology of our patient groups. However, our treatment protocols, hospitalization lengths, and costs remain the same. Our patient profile and treatment protocols remain similar, but COVID precautions add an extra burden. Amaç: COVID salgını yeni tıbbi protokolleri zorunlu kılmıştır. COVID önlemleri, cerrahi algoritmaları da tıbbi maliyetlerde bir değişikliğe neden olacak şekilde değiştirmiştir. Bu çalışma, Baş ve Boyun (H&N) bölgesi deri tümörü olan hastaların COVID dönemindeki tıbbi maliyetleri ve altta yatan nedenleri açıklığa kavuşturmayı amaçlamaktadır. Gereç ve Yöntem: Kliniğimizde COVID salgını öncesi ve sırasında H&N tümörleri nedeniyle ameliyat edilen hastalar cinsiyet, yaş, etiyoloji, PPE kullanımı, tedaviler ve toplam maliyetlere göre geriye dönük olarak analiz edildi. Önemli değişiklikler için istatistiksel analiz yapıldı. Tartışma: COVID, hasta gruplarımızın etiyolojisini değiştirmiştir. Ancak tedavi protokollerimiz, hastanede kalma sürelerimiz ve maliyetlerimiz aynı kalmıştır. Hasta profilimiz