Introduction: The ongoing Covid-19 pandemic and the subsequent nationwide lockdown, has impacted all aspects of society including medical profession. In hospitals, the focus has mainly shifted to prevention and treatment of Covid-19 infection. Owing to this, all elective surgeries were postponed and only emergent surgeries were performed. This has affected the patients differently depending on the progression of disease and development of complications. Materials and Methods: A well-structured telephonic scripted questionnaire was administered to all patients who were given appointment for any elective surgery. Data was collected regarding the status of disease including complications and the patient's perspective on method of treatment. Patients who developed complications or underwent emergency surgery or surgery elsewhere were excluded. Results: The male to female ratio was 2.3:1. Mean age of patients was 41.16 years. A total of 86 patients were included in the study. Almost all (98.8%) were aware that the lockdown and withholding of elective surgeries was to prevent spread of coronavirus infection. Among 34 patients with complications, 88.2% were willing to undergo surgical procedure and 73.5% were willing to visit hospital within a week or two. Among patients without complications, 71.2% were willing to continue treatment on wait and watch policy, for a period of 2 months or more (45.7%). 93.5% of patients avoided visit to hospital due to risk of infection. Discussion: Patient's attitude towards the choice of treatment (wait and watch Vs surgery) mainly depended on the progression of disease. It is critical, during these tough times of Covid-19 pandemic, that risks are weighed against bene ts to decide the line of management for patients waiting for elective surgeries.

To aggressively address COVID-19, CMS recognizes that conservation of critical healthcare resources is essential, in addition to limiting exposure of patients and staff to the virus that causes COVID-19. CMS also recognizes the importance of reducing burdens on the existing health system and maintaining services while keeping patients and providers safe. CMS, in collaboration with medical societies and associations, recently created recommendations to postpone non-essential surgeries and other procedures. This document provides recommendations to limit those medical services that could be deferred, such as non-emergent, elective treatment, and preventive medical services for patients of all ages.

Background:Due to its strong antimicrobial activity, silver is a commonly used adjunct in wound care. However, it also has the potential to impair healing by exerting toxic effects on keratinocytes and fibroblasts. The published literature on the use of silver in wound care is very heterogeneous, making it difficult to generate useful treatment guidelines.Methods:A search of high-quality studies on the use of silver in wound care was performed on PubMed. A detailed qualitative analysis of published articles was performed to evaluate the evidence for the use of silver in infected wounds, clean wounds, burns, and over closed surgical incisions.Results:Fifty-nine studies were included in this qualitative analysis. We found that, overall, the quality of the published research on silver is poor. While there is some evidence for short-term use of dressings containing nanocrystalline silver in infected wounds, the use of silver-containing dressings in clean wounds and over closed surgical incisions is not indicated. Negative-pressure wound therapy accelerates the healing of contaminated wounds, especially when silver is used as an adjunct. For burns, silver sulfadiazine slows healing and should not be used. Instead, nanocrystalline silver, or alternatives such as octenidine and polyhexanide, lead to less infection and faster healing.Conclusions:In infected wounds, silver is beneficial for the first few days/weeks, after which nonsilver dressings should be used instead. For clean wounds and closed surgical incisions, silver confers no benefit. The ideal silver formulations are nanocrystalline silver and silver-coated polyurethane sponge for negative-pressure wound therapy. Silver sulfadiazine impairs wound healing. Proper use of silver-containing dressings is essential to optimize wound healing.

Background: The coronavirus disease 2019 (COVID-19) pandemic led to a drastic decline in the number of elective surgeries performed in the United States. Many national societies and local governments provided recommendations for surgeons to initially suspend and progressively resume elective surgery. The authors used a survey to the American Council of Academic Plastic Surgeons (ACAPS) to assess the effect on plastic surgeons. Methods: An electronic survey questionnaire was distributed to 532 members of ACAPS. Data on individual and plastic surgery practice demographics, COVID-19 prevention measures, and procedures or services that were being performed or delayed were collected and analyzed. Results: An estimated 161 members (30.2%) completed the survey. Changes in hospital policy were cited as the most common reason (89%) for determining which procedures were currently offered. Results vary by specialty. Notably, <10% of respondents who normally offered aesthetic procedures currently offered any procedures during the survey. Subspecialty-specific results and prevention measures when seeing clinic patients are further summarized and discussed. Conclusions: Plastic surgeons have seen a drastic decrease in the variety of procedures and services they are allowed to offer during the COVID-19 pandemic. To help plan a return to normalcy, surgeons should create and implement plans to protect patients and staff from coronavirus transmission, assure financial solvency, and consider the effects of delayed surgeries on both the physical and mental health of their patients. In doing so, surgeons and their patients will be better prepared in the event of a resurgence of the virus.

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