A Protocol for Safe Head and Neck Reconstructive Surgery in the COVID-19 Pandemic

Area of Science:

• Plastic Surgery
• Infectious Disease Control
• Surgical Safety

Background:

• The COVID-19 pandemic poses significant risks to healthcare systems and providers, particularly plastic surgeons performing aerosol-generating procedures.
• Operations of the upper aerodigestive tract, including head and neck reconstruction and craniomaxillofacial surgeries, present a high risk of virus transmission to surgical teams.

Purpose of the Study:

• To propose evolving algorithms and recommend precautions for safely performing high-risk head and neck reconstruction and facial trauma surgeries during the COVID-19 pandemic.
• To maintain provider safety while ensuring efficient patient care throughout the pandemic.

Main Methods:

• Development of updated surgical algorithms and guidelines for head and neck reconstruction and facial trauma procedures.
• Emphasis on preoperative COVID-19 testing for patients and staff.
• Mandating appropriate personal protective equipment (PPE) for all surgical team members.
• Implementation of operative techniques and principles designed to minimize operative time and viral aerosolization.

Main Results:

• The proposed guidelines aim to mitigate the risk of SARS-CoV-2 transmission during aerosol-generating surgical procedures.
• Implementation of these measures is expected to enhance the safety of plastic surgeons and the entire surgical team.
• The strategies support the continuation of essential reconstructive and trauma surgeries during the pandemic.

Conclusions:

• Plastic surgeons can continue to provide critical care for head and neck reconstruction and facial trauma patients by adopting specific safety protocols.
• Preoperative COVID-19 testing, rigorous use of PPE, and modified surgical techniques are essential for minimizing viral transmission.
• These evolving algorithms ensure the safety of healthcare providers while delivering efficient patient care during the COVID-19 pandemic.