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Table of Contents
LETTER TO THE EDITOR
Year : 2021  |  Volume : 29  |  Issue : 1  |  Page : 76-77

Plastic and reconstructive surgery procedures during the COVID-19 pandemic: A paradigm shift


Department of Plastic Reconstructive and Aesthetic Surgery, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University Faculty of Medicine, Ankara, Turkey

Date of Submission10-Jul-2020
Date of Acceptance23-Aug-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Dr. Galip Gencay Ustun
Department of Plastic Reconstructive and Aesthetic Surgery, Research and Application Center for the Treatment of Cleft Lip and Palate and Craniomaxillofacial Deformities, Hacettepe University Faculty of Medicine, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjps.tjps_74_20

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How to cite this article:
Boynuyogun E, Ustun GG, Ozgur F. Plastic and reconstructive surgery procedures during the COVID-19 pandemic: A paradigm shift. Turk J Plast Surg 2021;29:76-7

How to cite this URL:
Boynuyogun E, Ustun GG, Ozgur F. Plastic and reconstructive surgery procedures during the COVID-19 pandemic: A paradigm shift. Turk J Plast Surg [serial online] 2021 [cited 2021 Jan 22];29:76-7. Available from: http://www.turkjplastsurg.org/text.asp?2021/29/1/76/305909



The World Health Organization has officially declared COVID-19 as a pandemic on March 11, 2020.[1] On the same date, the first COVID-19 case in Turkey has been announced. As plastic surgeons, we are not at the front line in combat with COVID-19. However, the insidious course and infectivity during the asymptomatic phase of the disease forced us to change our practice. Here, we aim to describe how we handle this period, the changing workload and the protective measures we take as one of the biggest plastic surgery departments in Turkey.

Following the recommendations of Ministry of Health, all scheduled elective surgeries have been cancelled.[2] As an end point, May 31, 2020 was stated because of normalization process has started on June 1, 2020 in Turkey.[3] In the first 80 days after public announcement of the first COVID-19 case, the number of surgeries was reduced to 118, comparing to 904 cases last year in the same time period. Patient characteristics and details of surgeries between March 11, 2019–May 31, 2019 and March 11, 2020–May 31, 2020 are summarized in [Table 1]. The number of outpatient clinic applications reduced from 3630 to 588 and bed occupancy rate reduced from 68.92% to 32.7% in compared period (P < 0.001, according to Fisher's exact test) [Table 2]. As a pandemic hospital, we aimed to increase the number of vacant beds, human resources, and physical spaces for the fight against the COVID-19, while reducing use of personal protective equipment (PPE) for possible need in the future.
Table 1: Comparison of patient characteristics, type of anesthesia, and type of surgery during COVID-19 pandemic and same time frame last year

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Table 2: Comparison of outpatient clinic applications, bed occupancy rates and number of surgeries during COVID-19 pandemic and same time period last year

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Comprehensive protective measures were taken by our staff. There was no confirmed COVID-19 positivity in our staff. Each patient and companion who came to the hospital were questioned about COVID-19 symptoms and contact history at main entrances of hospital. Computed tomography and reverse transcriptase-polymerase chain reaction test were performed regularly for every patient who is required to undergo surgery. All informed consent forms were revised according to COVID guidelines. Patients were informed about the risk of transmission of COVID-19 during their hospital stay and potential risks of infection with COVID-19. All surgical staff were equipped with PPE such as N95 mask or surgical mask, eyewear, gown, double surgical gloves, and protective shield. Hospitalization period has been minimized. The number of companions was limited and visitors were restricted.[4] We started using online consultation and telemedicine modalities which are useful methods for follow-ups.

Online education platform that ease to interact with the participants and offer a different learning experience has been previously discussed.[5] Educational lectures, case presentations and article reviews were executed using these platforms. Four of our residents working in COVID clinics were able to attend daily courses from home and workplaces. We think this arrangement not only helped continuation of their education in residency, but also keeping a bond with their own department helped them coping with daily stress.[6]

The COVID-19 outbreak continues to spread worldwide, and its course is changing our routines. Interdisciplinary cooperation and communication with health-care administration is essential. We hope to see the beginning of normalization process in plastic surgery soon, with collaboration of all stakeholders.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
WHO Director-General Speeches. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the -media-briefing-on-covid-19---11-march-2020. [Last accessed on 2020 Apr 30].  Back to cited text no. 1
    
2.
Republic of Turkey Ministry of Health General Directorate of Health Services Department of Patient Rights and Medical Social Services. Available from: https://hasta.saglik.gov.tr/TR,64508/elektif-islemlerin-ertelenmesi-ve-diger-alinacak-tedbirler.html. [Last accessed on 2020 Apr 30].  Back to cited text no. 2
    
3.
Anadolu Agency Latest on Coronavirus Outbreak.Available from: https://www.aa.com.tr/en/latest-on-coronavirus-outbreak/normalization-in-turkey-starts-after-virus-restrictions/1860901. [Last accessed on 2020 Aug 09].  Back to cited text no. 3
    
4.
Andrews BT, Garg R, Przylecki W, et al. COVID-19 pandemic and its impact on craniofacial surgery. J Craniofac Surg 2020;31:e620-e22.  Back to cited text no. 4
    
5.
Wlodarczyk JR, Wolfswinkel EM, Carey JN. Coronavirus 2019 video conferencing: Preserving resident education with online meeting platforms. Plast Reconstr Surg 2020;146:110e-1e.  Back to cited text no. 5
    
6.
Demirdover C. The impact of COVID-19 pandemic on plastic reconstructive and aesthetic surgery practice. Turk J Plast Surg 2020;28:133-4.  Back to cited text no. 6
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