Emergent Aerosols Generating Procedures in Oral & Maxillofacial Surgery in COVID-19 Pandemic

Abstract

Introduction: COVID-19 has a great impact on the practice of maxillofacial surgery. To fulfill our professional obligations, we continued the services of department by carrying out emergency procedures most of which include aerosol generating procedures which need special consideration and are in high risk category in this current pandemic. In this study we interrogated the literature and evaluated the procedures, their modification and the protocols followed by our team. Objective: To study and analyze the emergency aerosol generating procedures performed, modifications done according to current situation, duration of procedures and recommended precautionary measures followed. Methods: We performed a retrospective observational study in the Department of Oral & Maxillofacial Surgery, Mayo Hospital, Lahore. The patients who presented in emergency and underwent emergency aerosol generating procedures in the duration of two months and 10 days from 1st April'20-10th June'20 were included in the study. Diagnosis, type of emergency procedures performed, duration of procedure, type of anesthesia, precautionary measures followed according to the recommended guidelines and any modification made in the procedures in the current pandemic was assessed and logged on structured proformas. Results: A total of 542 patients were included in the study. Out of 358 cases of trauma closed reduction was performed in 160 cases, open reduction and internal fixation in 49 cases, 19 incision and drainage, 5 debridements, 76 wound irrigation, 7 tracheostomies, 10 resections along with or without neck dissections, 151 laceration repairs, 3 flap divisions, 32 extractions and 2 resection of the lesions along with tracheostomy. Conclusion: During this pandemic, there is a great chance of airborne transmission of virus during aerosol generating procedures. Best possible treatment and care should be provided to the patient along with ensuring protection of patient and the hospital staff by modifying the procedural techniques and following the recommended safety protocols.