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Abstract Hand surgery services had to rapidly adapt to the coronavirus disease 2019 (COVID-19) pandemic. The aim of the Reconstructive Surgery Trials Network #RSTNCOVID hand surgery survey was to document the changes made in the United Kingdom and Europe and consider which might persist.A survey developed by the Reconstructive Surgery Trials Network, in association with the British Association of Hand Therapists, was distributed to hand surgery units across the UK and Europe after the first wave of COVID-19. It was completed by one consultant hand surgeon at each of the 44 units that responded.Adult and paediatric trauma was maintained but elective services stopped. Consultations were increasingly virtual and surgery was more likely to be under local anaesthetic and in a lower resource setting.Many of the changes are viewed as being beneficial. However, it is important to establish that they are clinically and cost effective. These survey results will help prioritise and support future research initiatives.*The authors wish to acknowledge the RSTN Hand Collaborative; an official list of collaborators/individuals and institutions that participated in the study can be found in its entirety in the Declarations section.

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