Impact of firework restrictions on emergency plastic surgery cases: A five-year comparison of restricted vs. non-restricted New Year's Days and Easter Sunday (2021-2025).

内容摘要

Traumatic injuries requiring plastic surgical intervention exhibit seasonal and event-related variations. To isolate the contribution of pyrotechnic devices to acute trauma burden, we compared a festive period in which private fireworks are traditionally used (New Year's Day, NYD) with a holiday on which fireworks do not form part of the festivities (Easter Sunday), serving as a non-pyrotechnic control. We compared the incidence, characteristics and diagnosis-related group (DRG)-based costs of emergency plastic surgery presentations on NYD and Easter Sunday over a five-year period. A retrospective multicenter study was conducted at two care centers in Germany. Data from NYD and Easter Sunday from 2021 to 2025 were analyzed. Variables included the number of patients, mean age, gender distribution, number of surgical interventions, standard and intensive care admissions, length of hospital stay, and estimated costs of inpatient treatment based on DRGs. A total of 235 patients were included (155 on NYD and 80 on Easter Sunday). NYD was associated with a higher number of emergency presentations, younger patient cohort (mean age: 37.5 vs. 45.75 years, p = 0.058), and predominance of male patients. The number of operative interventions and ICU admissions, length of stay, and healthcare costs were higher on NYD compared to Easter Sunday (mean cost per patient: €14.484 vs. €3.893, p = 0.22). Beyond individual cases, fireworks-related injuries also pose a risk of mass casualty events with substantial implications for burn care capacity and emergency preparedness, underscoring the catastrophic potential of New Year-associated celebratory activities. During the nationwide fireworks bans during COVID-19 pandemic, which created a natural quasi-experiment, we observed a marked reduction in the absolute number of firework-related injuries, injury severity, emergency operations, intensive care admissions, and associated healthcare costs. Overall, NYD places a significantly greater burden on plastic surgery emergency services than Easter Sunday in terms of resource utilization and economic impact. Fireworks availability appears to be a major and potentially modifiable driver of complex trauma requiring plastic surgical care. These findings highlight the importance of anticipatory resource planning, disaster preparedness, and targeted prevention strategies for avoidable, event-related injuries.