Head and neck free flap reconstruction under the COVID-19 pandemic

Nagoya J Med Sci. 2024 Aug;86(3):472-478. doi: 10.18999/nagjms.86.3.472.

Abstract

High perioperative mortality and complication rates during the coronavirus disease 2019 (COVID-19) pandemic have been reported. In head and neck reconstruction, not only is patient safety important, but the prevention of infection introduced by the surgical team is also important because the procedure is performed in close proximity to the upper respiratory tract. In addition, recent studies have reported an increased risk for thrombus formation after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 vaccination, which is problematic for microsurgical reconstruction procedures. At the authors' institution, patients undergoing head and neck reconstruction are requested to stay home for 2 weeks and undergo screening tests for COVID-19 before admission. Surgeons use standard personal protective equipment during surgery. There was no significant difference in the rate of total flap necrosis between the COVID-19 and non-pandemic periods or large difference of perioperative complication rates between vaccinated and non-vaccinated patients. No surgery-related infections among the surgical staff were also found.

Keywords: COVID-19; microsurgical reconstruction; thrombus formation.

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Female
  • Free Tissue Flaps*
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Male
  • Middle Aged
  • Personal Protective Equipment
  • Plastic Surgery Procedures* / methods
  • Postoperative Complications / epidemiology
  • SARS-CoV-2