Facial Plastic and Reconstructive Surgery During the COVID-19 Pandemic

Shokri, Tom; Saadi, Robert; Liaw, Jeffrey; Bann, Darrin V.; Patel, Vijay A.; Goyal, Neerav; Lighthall, Jessyka G.

doi:10.1097/sap.0000000000002492

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…Three studies (14 per cent) were retrieved in April 12 , 36 , 37 , nine (43 per cent) in May 16 , 38–45 and nine (43 per cent) in June 2020 46–54 . Regarding study type, eleven (52 per cent) were scoping reviews 12 , 16 , 37 , 38 , 40 , 44 , 46 , 48–50 , 53 , eight (38 per cent) systematic reviews 36 , 39 , 41 , 42 , 45 , 47 , 51 , 54 and two (10 per cent) were narrative reviews that fulfilled the inclusion criteria 43 , 52 .…”

Section: Resultsmentioning

confidence: 99%

“…Methodological quality scores ranged from low to moderate for the 21 studies ( Table 2 ). Of the 13 studies appraised using the AGREE II instrument 12 , 16 , 37 , 38 , 40 , 43 , 44 , 46 , 48–50 , 52 , 53 , only one (score 63 per cent) 46 scored over 50 per cent. Scores of the other 12 studies ranged from 26–49 per cent.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Evidence, not eminence, for surgical management during COVID-19: a multifaceted systematic review and a model for rapid clinical change

et al. 2021

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Background Coronavirus (COVID-19) forced surgical evolution worldwide. The extent to which national evidence-based recommendations, produced by the current authors early in 2020, remain valid, is unclear. To inform global surgical management and a model for rapid clinical change, this study aimed to characterize surgical evolution following COVID-19 through a multifaceted systematic review. Methods Rapid reviews were conducted targeting intraoperative safety, personal protective equipment and triage, alongside a conventional systematic review identifying evidence-based guidance for surgical management. Targeted searches of PubMed and Embase from 31 December 2019 were repeated weekly until 7 August 2020, and systematic searches repeated monthly until 30 June 2020. Literature was stratified using Evans’ hierarchy of evidence. Narrative data were analysed for consistency with earlier recommendations. The systematic review rated quality using the AGREE II and AMSTAR tools, was registered with PROSPERO, CRD42020205845. Meta-analysis was not conducted. Results From 174 targeted searches and six systematic searches, 1256 studies were identified for the rapid reviews and 21 for the conventional systematic review. Of studies within the rapid reviews, 903 (71.9 per cent) had lower-quality design, with 402 (32.0 per cent) being opinion-based. Quality of studies in the systematic review ranged from low to moderate. Consistency with recommendations made previously by the present authors was observed despite 1017 relevant subsequent publications. Conclusion The evidence-based recommendations produced early in 2020 remained valid despite many subsequent publications. Weaker studies predominated and few guidelines were evidence-based. Extracted clinical solutions were globally implementable. An evidence-based model for rapid clinical change is provided that may benefit surgical management during this pandemic and future times of urgency.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Evidence, not eminence, for surgical management during COVID-19: a multifaceted systematic review and a model for rapid clinical change

et al. 2021

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“…Due to the exposure risk to surgical teams in the setting of operative facial trauma treatment, our findings are consistent with prior guidelines that have called for a conservative approach to favor nonoperative or delayed operative management whenever possible. 18–20…”

Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID- 19) is a viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is responsible for the ongoing COVID-19 pandemic. COVID-19 has been shown to have a high transmissibility with asymptomatic cases estimated to be as high as 40 to 45% of infections.…”

Section: Introductionmentioning

confidence: 99%

Quantifying Aerosol Generation in Maxillofacial Trauma Repair Techniques

McCann

Singerman

Coxe

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

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Study Design Cadaveric simulation study. Objective The novel coronavirus (COVID-19), which can be transmitted via aerosolized viral particles, has directed focus on protection of healthcare workers during procedures involving the upper aerodigestive tract, including maxillofacial trauma repair. This study evaluates particle generation at different distances from open reduction and internal fixation (ORIF) of maxillofacial injuries in the intraoperative setting to reduce the risk of contracting airborne diseases such as COVID-19. Methods Two cadaveric specimens in a simulated operating room underwent ORIF of midface and mandible fractures via intraoral incisions as well as maxillomandibular fixation (MMF) using hybrid arch bars. ORIF was performed with both self-drilling screws and with the use of a power drill for creating guide holes. Real-time aerosol concentration was measured throughout each procedure using 3 particle counters placed 0.45, 1.68, and 3.81 m (1.5, 5.5, and 12.5 feet, respectively) from the operative site. Results There was a significant decrease in particle concentration in all procedures at 1.68 m compared to 0.45 m, but only 2 of the 5 procedures showed further significant decrease in particle concentration when going from 1.68 to 3.81 m from the operative site. There was significantly less particle concentration generated at all distances when using self-drilling techniques compared to power drilling for ORIF. Conclusion Consideration of using self-drilling screwing techniques as well as maintaining physical distancing protocols may decrease risk of transmission of airborne diseases such as COVID-19 while in the intraoperative setting.

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“…The first case in India was on January 30, 2020, and now around 30 million cases and more than 413091 deaths (as of July 17, 2021) have been reported according to the Ministry Of Health and Family Welfare. Due to occupational hazard, nonessential procedures were reduced 1 .The pandemic has affected patient management and resident training.…”

Section: Introductionmentioning

confidence: 99%

Plastic Surgery Practice during COVID Times

Bhaskaran

Chandran

Rajan

2022

Indian J Plast Surg

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Introduction COVID-19 has affected plastic surgeons like never before. We conducted an all-India survey to find how the practice was affected among public/private sector, reconstructive/aesthetic practice, and consultants/residents. We have proposed some solutions to the identified problems, which are supported by previous literature. Methods A survey framed in Google forms was circulated through WhatsApp and emails in August 2020. Closed and semiopen questions regarding changes in personal and professional lives, coping strategies adopted, and open questions for suggestions in improving practice, academics and measures to tackle the pandemic were included. Responses were collected in an Excel sheet and analysis done using SPSS software. Results A total of 220 consented responses were obtained. Public hospital practitioners had to bear the COVID-related administrative as well as executive works, especially residents, which led to anxiety, family concern, burnout, and concern about the loss of skills and academics. Patient interaction was also reduced. Aesthetic surgeons bore more financial loss. Conclusions Plastic surgeons in India faced decrease in caseload, financial loss, COVID-related duties, workload for residents, reduced academics, family and mental health problems, difficulty with personal protection equipment (PPE) during surgeries, and queries from patients. These can be solved by doing cases within the limits of protocols and safety, pooling public and private sector for COVID duties, rotating residents' groups to reduce workload, using telemedicine for academics and patient consultations, and providing social support groups to surgeons.

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Facial Plastic and Reconstructive Surgery During the COVID-19 Pandemic

Cited by 11 publications

References 12 publications

Evidence, not eminence, for surgical management during COVID-19: a multifaceted systematic review and a model for rapid clinical change

Evidence, not eminence, for surgical management during COVID-19: a multifaceted systematic review and a model for rapid clinical change

Quantifying Aerosol Generation in Maxillofacial Trauma Repair Techniques

Plastic Surgery Practice during COVID Times

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