Framework for prioritizing head and neck surgery during the COVID-19 pandemic
© 2020 Wiley Periodicals, Inc..
The COVID-19 pandemic has placed an extraordinary demand on the United States health care system. Many institutions have canceled elective and non-urgent procedures to conserve resources and limit exposure. While operational definitions of elective and urgent categories exist, there is a degree of surgeon judgment in designation. In the present commentary, we provide a framework for prioritizing head and neck surgery during the pandemic. Unique considerations for the head and neck patient are examined including risk to the oncology patient, outcomes following delay in head and neck cancer therapy, and risk of transmission during otolaryngologic surgery. Our case prioritization criteria consist of four categories: urgent-proceed with surgery, less urgent-consider postpone > 30 days, less urgent-consider postpone 30 to 90 days, and case-by-case basis. Finally, we discuss our preoperative clinical pathway for transmission mitigation including defining low-risk and high-risk surgery for transmission and role of preoperative COVID-19 testing.
| Errataetall: |
CommentIn: Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Jul;130(1):127-128. - PMID 32451230 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Head & neck - 42(2020), 6 vom: 27. Juni, Seite 1159-1167 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Topf, Michael C [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 10.06.2020 Date Revised 18.12.2020 published: Print-Electronic CommentIn: Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Jul;130(1):127-128. - PMID 32451230 Citation Status MEDLINE |
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| doi: |
10.1002/hed.26184 |
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| funding: |
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| 520 | |a The COVID-19 pandemic has placed an extraordinary demand on the United States health care system. Many institutions have canceled elective and non-urgent procedures to conserve resources and limit exposure. While operational definitions of elective and urgent categories exist, there is a degree of surgeon judgment in designation. In the present commentary, we provide a framework for prioritizing head and neck surgery during the pandemic. Unique considerations for the head and neck patient are examined including risk to the oncology patient, outcomes following delay in head and neck cancer therapy, and risk of transmission during otolaryngologic surgery. Our case prioritization criteria consist of four categories: urgent-proceed with surgery, less urgent-consider postpone > 30 days, less urgent-consider postpone 30 to 90 days, and case-by-case basis. Finally, we discuss our preoperative clinical pathway for transmission mitigation including defining low-risk and high-risk surgery for transmission and role of preoperative COVID-19 testing | ||
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