Management of Personal Protective Equipment in Plastic Surgery in the Era of Coronavirus Disease

摘要

In the era of the novel coronavirus pandemic, all elective and nonessential plastic surgeries can be delayed. Nevertheless, plastic surgery procedures such as removal of cancer should be given priority. The management of plastic surgery patients should be planned to reduce the risk of the severe acute respiratory syndrome coronavirus 2 transmission among patients, clinical staff, and surgeons. Health care workers should protect themselves and prevent transmission in the healthcare setting. Nowadays, in our hospital, the stockpile of personal protective equipment (PPE) is insufficient, particularly of medical masks and respirators. An inappropriate use of PPE supply should be avoided. In particular, few PPEs are given to our Plastic Surgery Unit rather than other Units of the same Department such as Otorhinolaryngology or Oral and Maxillofacial Surgery where there is a high transmission risk during oral medical examination and procedures. For this reason, we developed strategies to optimize the use of PPEs. For all surgical procedures performed in the trunk and limbs, patients without respiratory symptoms are given a surgical mask to wear during preoperative evaluation, surgery, and postoperative care. In these procedures, the surgeon uses a surgical mask. In case of suspected patients with respiratory symptoms, confirmed coronavirus disease 2019 (COVID-19) patients, or patients undergoing head–neck and facial plastic surgery, the use of respirators (N95/P2/FFP2 or equivalent) is highly recommended for the surgeon. If testing for COVID-19 is available, it should be reserved to patients undergoing head and neck surgical procedures or facial plastic surgical procedures, especially if performed in local anesthesia, where the use of patient medical mask is not feasible. Hence, if a negative result is obtained, the use of respirators for operating room staff without close contact with patient can be avoided.