Patient, Practice Safety During the Pandemic

March 2020 marked the start of the United States’ COVID-19 response with state-wide stay-at-home orders, a moratorium on nonurgent and elective surgery throughout most of the country, and shortages on personal protective equipment (PPE) as the first wave of infected people crowded hospitals.

Several weeks later, depending on the state, private practices began the reopening process, with multiple new safety protocols in place to protect patients and medical staff.

To generate data on these protocols, a study in the Aesthetic Surgery Journal reports on a survey used to assess the safety of plastic surgery during the pandemic, by examining the preoperative prevalence of the virus, the risk of post-operative infection, outcomes and resource utilization for these cases, and the risk to office staff.

The Los Angeles Society of Plastic Surgeons (LASPS) sent a 17-question survey to approximately 409 plastic surgeons certified by the American Board of Plastic Surgery (ABPS) in late July 2020, inquiring about their cases since reopening in late May.

The survey was distributed during a local Los Angeles COVID-19 surge and asked about procedures performed in the eight- to-10-week period since reopening, including the number performed, testing policies, surgical complications, and cases among staff.

Reminders were sent every other day during the one-week period the survey was open, and recipients were assured that results shared would be anonymous.

As the survey did not collect patient-specific information and respondents were untraceable, study researchers were not required to submit approval through the institutional review board nor acquire patient consent.

Researchers followed the Declaration of Helsinki Guidelines and used best ethical guidelines. Information gathered about the prevalence of COVID-19 during the study period was retrieved from the website of the Los Angeles County Department of Public Health.

In total, 112 surgeons reported 5633 surgeries since resuming elective surgery. A total of 103 (91.96%) surgeons obtained a preoperative SARS-CoV-2 polymerase chain reaction (PCR) test for every patient. Of these PCR tests, 41/5881 (0.69%) were positive. Positive tests within two weeks post-op occurred in 7/5380 (0.13%) surgical patients, 3/8506 (0.04%) injectable patients, and 6/2519 (0.24%) energy therapy patients.

Of the surveyed practices, nine reported at least one staff member with COVID-19. All cases were reported as mild, with no hospitalizations or deaths.

Study researchers conclude that according to collected data, plastic surgery can be performed safely during a COVID-19 surge by those certified through ABPS.

“The results of our study represent a relief for plastic surgeons and their patients,” the authors write. “With no serious cases of postoperative COVID-19, no hospitalizations, and no deaths, this shows that plastic surgery can safely be done during the pandemic. Undoubtedly, this is a reflection of safety protocols such as those developed by The Aesthetic Society’s COVID-19 Task Force being followed, the fact that plastic surgery patients tend to be younger and healthier than patients requiring emergency or urgent surgery, and that many elective plastic surgery procedures are not classified as major surgery.”

Reference:

Teitelbaum S, Diaz J, Singer R. Can outpatient plastic surgery be done safely during a covid-19 surge? Results of a July 2020 Los Angeles survey and literature review. Aesthetic Surgery Journal. 2021;41(1):98-108.