Objective The World Health Organization declared COVID-19 a pandemic on 11th March 2020. The UK government introduced strict social distancing measures on 23rd March 2020, with the country put into a full lockdown to further halt the spread of the virus. The aims of this article are to ascertain whether there was a rise in the incidence of deliberate self-harm (DSH) presentations to the emergency department at a level one trauma center associated with the introduction of lockdown measures. Method An observational study from a level one trauma center was carried out. Retrospective data from 23rd March 2020 to 1st May 2020 was collected and compared to the same time period in 2019. Data was collected from coded electronic patient records. Results Total attendances to the Emergency Department (ED) reduced from 2019 to 2020 (5198 and 3059 respectively). There was a significant increase in the total number of self-harm presentations between 2019 and 2020 (103 vs 113, p-value <0.001) as well as paracetamol, NSAID and opiate overdoses, with more cases requiring hospital admission in 2020 vs 2019. Conclusions Societal lockdown measures secondary to the COVID-19 pandemic have had a significant effect on the mental health of patients. One way this can be detected is through an increased incidence and severity of deliberate self-harm injuries presenting to the ED. These findings, in conjunction with the available, literature provide valuable implications for community and emergency physicians and psychiatrists for any future wave of disease or pandemic.
Wound management is a major clinical challenge and puts a significant financial burden on the NHS. Because of the rise in long-term conditions including diabetes, obesity and an ageing population, practitioners regularly encounter a wide variety of wound types. In recent years, there has been a resurgence of interest in the use of medical-grade honey in the management of wounds. Honey is anti-inflammatory in action and has the capability to treat local infection, promote autolytic debridement, deodorise wounds and promote granulation tissue. Revamil is a recent addition to the range of honey dressings available and is intended to manage the majority of problems that may arise during wound care episodes. The attributes of Revamil will be illustrated through four case studies.
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