Microsurgical Reconstruction in the Pandemic by Covid-19

Abstract

Introduction: The SARS-CoV-2 (COVID-19) Pandemic had a significant impact on the development of surgical services in general and forced the establishment of action protocols for the different pathologies in order to take maximum care of human resources and capacity. installed in hospitals to deal with this global contingency.

Objectives: To present a casuistry of 7 patients with microsurgical reconstruction of head and neck pathology in advanced stages and lower limb pathology during the COVID-19 pandemic.

Materials and Methods: retrospective work and physical and digital medical records were reviewed. Five patients with advanced head and neck disease and 2 patients with lower limb disease were included.

Results: Five patients underwent surgery for advanced head and neck disease: 3 patients with stage IVa squamous cell carcinoma of the oral cavity, 1 patient with stage IV advanced squamous cell carcinoma of the skin, and 1 patient with a complex fracture of the lower jaw due to a gunshot wound. With chronic oro-cutaneous fistula, with exposure to the osteosynthesis material, poor occlusion, and significant weight loss due to difficulty feeding. Two patients underwent surgery for the pathology of the lower limbs in the lower third of the leg, one for a severe open fracture with a soft tissue defect and the other for an arterial ulcer.

Conclusion: Microsurgical reconstructive surgery can be performed with good levels of safety for health personnel and for patients affected by advanced pathologies of the head and neck and other pathologies that require free flaps. It is essential to strictly respect the protocols to avoid contagion in the hospital environment, understanding that every patient who enters the hospital must be considered as COVID (+) until proven otherwise.