Plastic and Reconstructive Surgery in the Wake of the Eid al-Adha: A Single-Center, Five-Year Investigation
Authors: Tapan Mehmet , Yaşar Burak , Ergani Hasan Murat , Ceylan Süleyman Can 
Published: May 2024

(1) Background: The Festival of Sacrifice, commonly known as Eid al-Adha, has a profound religious and cultural impact on nations with a Muslim majority. This festival is celebrated every year in Muslim countries; however, it is a time in which patients present to the emergency department with serious injuries. In our study, we examined current injuries occurring during Eid al-Adha in one of the largest hospitals in Türkiye, providing the largest patient population to date. This included mapping tendon and maxillofacial injuries, a first in the literature. To the best of our knowledge, this is the largest case series of injuries sustained during Eid al-Adha. The significance of this study lies in its potential to significantly benefit patients and healthcare systems by providing reference data. (2) Methods: Patients admitted to Ankara City Hospital during Eid al-Adha between 2019 and 2023 were examined. The demographic characteristics, injury patterns, and injury sites of patients admitted on the four days of Eid al-Adha were collected and analyzed. Maxillofacial traumas during the festival were analyzed. Tendon injuries on the left hand, which is the most commonly injured body part in the literature, were mapped into a figure. To compare the change in the number of patients, a comparison was made with the number of patients in our hospital for four consecutive days 2 weeks before Eid. Statistical analysis was performed using IBM SPSS Statistics for Windows. (3) Results: A total of 610 patients, including 101 female and 509 male patients, were included in this study. A statistically significant increase (p < 0.001 for all years) in hospital admission due to injury was observed. Individuals between the ages of 30 and 40 years were the most frequently admitted patients (n = 182, 29.8%). Knife injuries were significantly more common in all patients (p < 0.001). When the total number of patients was evaluated in terms of injured areas where patients present to the emergency department, left-hand injuries were found to be significantly more common than injuries in other areas (p < 0.001 for all). The extensor pollicus longus tendon was the most commonly injured tendon among all extensor and flexor tendon injuries (n = 104). The most commonly injured tendon was the flexor tendon in zone 2 of the first finger (n = 45). This study showed that injuries to the extensor tendon in zone 1 of the fifth finger, the flexor tendon in zone 4 of the first finger, and the flexor tendon in zone 1 of the fifth finger were never seen. Twenty-five patients with maxillofacial injuries were admitted to the hospital. Orbital floor fractures were the most common type of maxillofacial injury. The anesthesia technique we preferred for all patients was local anesthesia (n = 267). Wide-awake local anesthesia no tourniquet (WALANT) was the second most preferred anesthetic technique. The number of patients who were selected in a random 4-day period for each year were compared with the number of patients who came during Eid al-Adha. The Mann–Whitney U tests revealed a significant increase in injuries on the first day of Eid al-Adha compared to non-festival days (p < 0.001). However, no significant differences were observed on the subsequent days or in the overall injury counts during the festival period (p = 0.841 for day 2, p = 0.151 for day 3, p = 0.310 for day 4). (4) Conclusions: According to this study, which is the largest known case series in the literature, the number of patients admitted to the hospital increased annually. In our study, we observed a significant increase in injuries only on the first day of Eid al-Adha compared to a randomly selected 4-day period of the same year. Left-hand extensor tendon injuries from a knife were the most common injuries in middle-aged men. The extensor pollicis longus tendon was the most commonly injured extensor tendon, with zones 3 and 4 being the most commonly affected. The flexor pollicis longus tendon was the most commonly injured flexor tendon in zone 2. During this period, patients may not only need hand surgery but also maxillofacial plastic surgery. We recommend, in addition to the indications I,n the literature that during Eid al-Adha, the WALANT technique should be widely adopted in patients where local anesthesia will be insufficient. We also recommend utilizing a diagram to manage the patient load during Eid al-Adha and prevent overburdening the healthcare system.