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DOI: 10.1055/s-0040-1714378
Plastic Surgery in the Time of COVID-19
Abstract
Background The novel coronavirus disease 2019 (COVID-19) has swept the world in the last several months, causing massive disruption to existing social, economic, and health care systems. As with all medical fields, plastic and reconstructive surgery has been profoundly impacted across the entire spectrum of practice from academic medical centers to solo private practice. The decision to preserve vital life-saving equipment and cancel elective procedures to protect patients and medical staff has been extremely challenging on multiple levels. Frequent and inconsistent messaging disseminated by many voices on the national stage often conflicts and serves only to exacerbate an already difficult decision-making process.
Methods A survey of relevant COVID-19 literature is presented, and bioethical principles are utilized to generate guidelines for plastic surgeons in patient care through this pandemic.
Results A cohesive framework based upon core bioethical values is presented here to assist plastic surgeons in navigating this rapidly evolving global pandemic.
Conclusion Plastic surgeons around the world have been affected by COVID-19 and will adapt to continue serving their patients. The lessons learned in this present pandemic will undoubtedly prove useful in future challenges to come.
Publication History
Received: 24 April 2020
Accepted: 16 June 2020
Article published online:
21 July 2020
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
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References
- 1 World Health Organization. Coronavirus disease 2019 (COVID-19) situation report-87. Accessed April 17, 2020 at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200416-sitrep-87-covid-19.pdf
- 2 Chen N, Zhou M, Dong X. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395 (10223): 507-513
- 3 Holshue ML, DeBolt C, Lindquist S. et al; Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382 (10) 929-936
- 4 Cao B, Wang Y, Wen D. et al. A trial of lopinavir–ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020; 382 (19) 1787-1799
- 5 Emanuel EJ, Persad G, Upshur R. et al. Fair allocation of scarce medical resources in the time of Covid-19. N Engl J Med 2020; 382 (21) 2049-2055
- 6 Cheng VCC, Lau SKP, Woo PCY, Yuen KY. Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection. Clin Microbiol Rev 2007; 20 (04) 660-694
- 7 COVID-19: recommendations for management of elective surgical procedures. Accessed March 24, 2020 at: https://www.facs.org/about-acs/covid-19/information-for-surgeons/elective-surgery
- 8 CDC. Healthcare facilities: managing operations during the COVID-19 pandemic. Accessed March 24, 2020 at: https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/guidance-hcf.html
- 9 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382 (16) 1564-1567
- 10 Ong SWX, Tan YK, Chia PY. et al. Air, surface environmental, and personal protective equipment contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA 2020. Doi: 10.1001/jama.2020.3227
- 11 Chang D, Xu H, Rebaza A, Sharma L, Dela Cruz CS. Protecting health-care workers from subclinical coronavirus infection. Lancet Respir Med 2020; 8 (03) e13
- 12 American College of Surgeons. COVID-19: guidance for triage of non-emergent surgical procedures. Accessed June 10, 2020 at: https://www.facs.org/covid-19/clinical-guidance/triage
- 13 Ranney ML, Griffeth V, Jha AK. Critical supply shortages — the need for ventilators and personal protective equipment during the Covid-19 pandemic. N Engl J Med . N Engl J Med 2020; 382 (18) e41
- 14 AO CMF. AO CMF international task force recommendations on best practices for maxillofacial procedures during COVID-19 pandemic. Accessed April 17, 2020 at: https://aocmf3.aofoundation.org/-/media/project/aocmf/aocmf/files/covid-19/ao_cmf_covid-19_task_force_guidelines.pdf
- 15 Smith AC, Thomas E, Snoswell CL. et al. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare 2020; 26 (05) 309-313
- 16 Greenhalgh T, Wherton J, Shaw S, Morrison C. Video consultations for covid-19. BMJ 2020; 368: m998
- 17 Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid-19. N Engl J Med 2020; 382 (18) 1679-1681
- 18 Fischer JP, Wes AM, Nelson JA. et al. Propensity-matched, longitudinal outcomes analysis of complications and cost: comparing abdominal free flaps and implant-based breast reconstruction. J Am Coll Surg 2014; 219 (02) 303-312
- 19 Pirro O, Mestak O, Vindigni V. et al. Comparison of patient-reported outcomes after implant versus autologous tissue breast reconstruction using the BREAST-Q. Plast Reconstr Surg Glob Open 2017; 5 (01) e1217
- 20 Albornoz CR, Bach PB, Mehrara BJ. et al. A paradigm shift in U.S. Breast reconstruction: increasing implant rates. Plast Reconstr Surg 2013; 131 (01) 15-23
- 21 Matros E, Albornoz CR, Razdan SN. et al. Cost-effectiveness analysis of implants versus autologous perforator flaps using the BREAST-Q. Plast Reconstr Surg 2015; 135 (04) 937-946
- 22 Yueh JH, Slavin SA, Adesiyun T. et al. Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg 2010; 125 (06) 1585-1595
- 23 Batdorf NJ, Lemaine V, Lovely JK. et al. Enhanced recovery after surgery in microvascular breast reconstruction. J Plast Reconstr Aesthet Surg 2015; 68 (03) 395-402
- 24 Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 1st ed. New York, NY: Oxford University Press; 1973
- 25 Chung KC, Pushman AG, Bellfi LT. A systematic review of ethical principles in the plastic surgery literature. Plast Reconstr Surg 2009; 124 (05) 1711-1718
- 26 Cordova LZ, Hunter-Smith DJ, Rozen WM. Patient reported outcome measures (PROMs) following mastectomy with breast reconstruction or without reconstruction: a systematic review. Gland Surg 2019; 8 (04) 441-451
- 27 Mallia P. Towards an ethical theory in disaster situations. Med Health Care Philos 2015; 18 (01) 3-11
- 28 Cordeiro E, Zhong T, Jackson T, Cil T. The safety of same-day breast reconstructive surgery: an analysis of short-term outcomes. Am J Surg 2017; 214 (03) 495-500
- 29 Poppler LH, Mundschenk MB, Linkugel A, Zubovic E, Dolen UC, Myckatyn TM. Tissue expander complications do not preclude a second successful implant-based breast reconstruction. Plast Reconstr Surg 2019; 143 (01) 24-34
- 30 Manrique OJ, Banuelos J, Abu-Ghname A. et al. Surgical outcomes of prepectoral versus subpectoral implant-based breast reconstruction in young women. Plast Reconstr Surg Glob Open 2019; 7 (03) e2119
- 31 Momeni A, Remington AC, Wan DC, Nguyen D, Gurtner GC. A matched-pair analysis of prepectoral with subpectoral breast reconstruction: is there a difference in postoperative complication rate?. Plast Reconstr Surg 2019; 144 (04) 801-807
- 32 Walia GS, Aston J, Bello R. et al. Prepectoral versus subpectoral tissue expander placement: a clinical and quality of life outcomes study. Plast Reconstr Surg Glob Open 2018; 6 (04) e1731
- 33 Parikh RP, Sharma K, Guffey R, Myckatyn TM. Preoperative paravertebral block improves postoperative pain control and reduces hospital length of stay in patients undergoing autologous breast reconstruction after mastectomy for breast cancer. Ann Surg Oncol 2016; 23 (13) 4262-4269
- 34 Versyck B, van Geffen GJ, Chin KJ. Analgesic efficacy of the Pecs II block: a systematic review and meta-analysis. Anaesthesia 2019; 74 (05) 663-673
- 35 Kowalski LP, Sanabria A, Ridge JA. et al. COVID-19 pandemic: Effects and evidence-based recommendations for otolaryngology and head and neck surgery practice. Head Neck 2020; 42 (06) 1259-1267
- 36 Lee ZH, Stranix JT, Rifkin WJ. et al. Timing of microsurgical reconstruction in lower extremity trauma: an update of the Godina paradigm. Plast Reconstr Surg 2019; 144 (03) 759-767
- 37 Haykal S, Roy M, Patel A. Meta-analysis of timing for microsurgical free-flap reconstruction for lower limb injury: evaluation of the Godina principles. J Reconstr Microsurg 2018; 34 (04) 277-292
- 38 Yoon AP, Mahajani T, Hutton DW, Chung KC. Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE) Group. Cost-effectiveness of finger replantation compared with revision amputation. JAMA Netw Open 2019; 2 (12) e1916509
- 39 Jeffers L. COVID-19 Financial Assistance to Health Care Industry. Arlington Heights, IL: American Society of Plastic Surgeons; 2020. . Accessed March 26, 2020 at: https://www.plasticsurgery.org/for-medical-professionals/covid19-member-resources/advocacy-efforts
- 40 Coronavirus (COVID-19): Small Business Guidance & Loan Resources. Accessed March 25, 2020 at: https://www.sba.gov/page/coronavirus-covid-19-small-business-guidance-loan-resources
- 41 Senate Approves Roughly $2 Trillion in Coronavirus Relief. Accessed March 26, 2020 at: https://www.wsj.com/articles/trump-administration-senate-democrats-said-to-reach-stimulus-bill-deal-11585113371
- 42 American Hospital Association. Hospitals and health systems face unprecedented financial pressures due to COVID-19. Accessed July 2, 2020 at: https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due
- 43 Truog RD, Mitchell C, Daley GQ. The toughest triage—allocating ventilators in a pandemic. N Engl J Med 2020; 382 (21) 1973-1975
- 44 Bennett KG, Berlin NL, MacEachern MP, Buchman SR, Preminger BA, Vercler CJ. The ethical and professional use of social media in surgery: a systematic review of the literature. Plast Reconstr Surg 2018; 142 (03) 388e-398e