A Protocol for Performing Reconstructive Microsurgery on Patients With COVID-19

Thioné, Alessandro; Sánchez‐García, Alberto; Pérez‐García, Alberto; García‐Vilariño, Elena; Salmerón‐González, Enrique; Balaguer-Cambra, Jorge

doi:10.1097/psn.0000000000000352

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…More specifically, COVID‐19 has affected both elective and emergent surgery procedures, across all specialties (Collaborative CO, 2020a ; Moletta et al, 2020 ). From stringent personal protective equipment (PPE) protocols to pre‐admission and discharge screening measures which have frequently led to the postponement of procedures and increased length of hospital stay respectively, SARS‐CoV‐2 has truly altered surgical life as we knew it (Miller et al, 2020 ; Patel et al, 2020 ; Prasad et al, 2021 ; Thione et al, 2021 ; Toro et al, 2021 ; Yuan & Jiang, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The influence of SARS‐CoV‐2 vaccination on post‐operative outcomes in microsurgery patients

et al. 2022

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Background The healthcare industry's efforts to immunize the global community against severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) have been unprecedented. Given the fast‐tracking of the novel vaccine, its short‐ and long‐term medical implications remain largely to‐be‐determined in most patient populations. This study aims to analyze 90‐day post‐operative outcomes in microsurgical patients, who have received or not received SARS‐CoV‐2‐vaccination, using a continuously updated federated electronic medical record network (TriNetX Inc, Cambridge, MA). Methods After screening 70 million de‐identified records, 16,799 microsurgery patients aged 18–99 meeting medical coding criteria were allocated into two cohorts. Cohort One received SARS‐CoV‐2‐vaccination prior to undergoing microsurgery whereas Cohort Two did not. Two equally sized cohorts, totaling 818 patients were created after propensity score matching for characteristics including: age, race, ethnicity, smoking, hypertension, heart disease, diabetes, obesity, chronic obstructive pulmonary disease, and history of SARS‐CoV‐2 exposure. Postoperative outcomes within 30‐, 60‐, and 90‐days of microsurgery were analyzed. Results Patients who were SARS‐CoV‐2‐immunized experienced significantly lower ( p < .01) surgical site infections (Absolute Risk Reduction (ARR)[95%CI]) = (3.79%–5.36% [0.84–8.54]) ICU admission (9.47%–9.82%[5.45–13.88]), generalized infections (7.68%–9.92%[3.15–14.64]), and hospitalizations (28.48%–32.57%[20.99–40.13]) within 30‐, 60‐, and 90‐days of microsurgery. Additionally, SARS‐CoV‐2‐vaccinated patients also experienced significantly less flap failure (2.49%[0.97–4.02]) and death (2.46%[0.96–3.97]) within 30‐ and 60‐days post‐operatively. Conclusion Our analysis examines the potential protective effect of SARS‐CoV‐2‐vaccination in microsurgical patients. Limitations include the retrospective nature of this analysis and the inherent reliance on medical coding. Future prospective studies are warranted to better understand if in fact pre‐operative SARS‐CoV‐2‐vaccination has the potential to protect against post‐operative microsurgery outcomes.

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Section: Introductionmentioning

confidence: 99%

The influence of SARS‐CoV‐2 vaccination on post‐operative outcomes in microsurgery patients

et al. 2022

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“…3,4 Many surgeons have devised innovative safety protocols to help these patients receive necessary procedures. [5][6][7] Studies have examined the effects of these altered protocols on patient course and complication rates, specifically in the context of microsurgical head and neck (HN) reconstruction. 8 Preliminary center-specific studies have demonstrated that, with adjusted safety protocols and careful patient selection, there has been significant difference in complications when these measures to mitigate viral exposure are taken.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Trends of Microsurgical Head and Neck Free Flap Reconstruction and Safety during the COVID-19 Pandemic

Bustos,

Elmer,

Veeramani

et al. 2024

J Reconstr Microsurg Open

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Background: The COVID-19 pandemic poses unprecedented challenges among patients with head and neck (HN) cancer that require oncologic and reconstructive surgeries. This study aims to identify differences in postoperative outcomes for patients who underwent microsurgical HN free flap reconstruction prior to vs. during the COVID-19 pandemic. Methods: A retrospective observational study using the ACS-NSQIP 2019-2020 database to identify patients with HN cancer who underwent a vascularized free tissue transfer was undertaken. Two cohorts were created: pre- and during COVID-19. Fisher’s exact test and the unpaired student’s t-test were used to evaluate differences in sociodemographic and clinical characteristics between the cohorts. Multivariable logistic regression was used to assess differences in reoperation rates between groups, as well as to identify potential risk factors for reoperation. Results: A total of 763 patients were analyzed. The mean age of patients in the overall cohort was 63.6 SD 11.5 years. Most patients were white (62.7%). Overall, no statistically significant difference was evidenced between cohorts in terms of immediate postoperative outcomes. Similarly, reoperation rates were similar between groups(p>0.05). Dependent functional status(p=0.021) and postoperative infection(p<0.001) were found to be risk factors for reoperation after holding other factors constant. Conclusion: HN flap reconstruction can be performed safely during the COVID-19 era. Standardized protocols for patient selection must be strictly followed to avoid disease progression and optimize surgical outcomes. Further studies assessing long-term outcomes during the pandemic are of utmost importance to elucidate the true impact of the COVID-19 pandemic on this population.

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State of the PSN Union

Wicklin¹

2021

Plastic Surgical Nursing

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A Protocol for Performing Reconstructive Microsurgery on Patients With COVID-19

Cited by 3 publications

References 17 publications

The influence of SARS‐CoV‐2 vaccination on post‐operative outcomes in microsurgery patients

The influence of SARS‐CoV‐2 vaccination on post‐operative outcomes in microsurgery patients

Trends of Microsurgical Head and Neck Free Flap Reconstruction and Safety during the COVID-19 Pandemic

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