Journal of Cutaneous and Aesthetic Surgery
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 13  |  Issue : 2  |  Page : 77-94

Recommendations for cutaneous and aesthetic surgeries during COVID-19 pandemic


1 The Venkat Center for Skin ENT & Plastic Surgery, Bengaluru, India
2 Department of Dermatology, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, India
3 Department of Dermatology, Sri B M Patil Medical College Hospital and Research Centre, BLDE University, Vijayapura, Karnataka, India
4 Skin & Laser Clinic, Hyderabad, Telangana, India
5 CUTIS Academy of Cutaneous Sciences, Bengaluru, Karnataka, India
6 Dr. Dinesh’s Skin & Hair Clinic, Chennai, Tamil Nadu, India
7 Department of Dermatology, Vardhaman Mahavir Medical College, Safdarjang Hospital, New Delhi, India
8 Department of Dermatology, Roots Institute of Dermatological Sciences, Bengaluru, Karnataka, India
9 Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
10 Cutis Institute, Calicut, Kerala, India
11 Department of Dermatology, Maharashtra Medical Foundation, Pune, India
12 Renewderm Centre, Mumbai, Maharashtra, India; Saifee Hospital, Mumbai, Maharashtra, India; Prince Aly Khan Hospital, Mumbai, Maharashtra, India
13 Department of Dermatology, Assam Medical College & Hospital, Dibrugarh, Assam, India
14 Wockhardt Hospital and Apollo Spectra Hospital, Mumbai, India
15 Department of Dermatology, Ashwini Rural Medical College, Solapur, Maharashtra, India

Correspondence Address:
A Somaiah Savitha
Department of Dermatology, Sapthagiri Institute of Medical Sciences & Research Centre, Bengaluru, Karnataka.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCAS.JCAS_83_20

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Background: Amid the coronavirus disease 2019 (COVID-19) pandemic, dermatologists must be prepared to restructure their practice of procedural dermatology and cutaneous aesthetic surgeries. The COVID-19 pandemic has presented several challenges and has ushered in several changes in practice such as teledermatology, with many physicians adopting virtual consultations and treatments. Performing procedures in the times of COVID-19 pandemic presents challenges such as risk of transmission to doctors and staff due to potential aerosolization, release of virus droplets during the procedures, and risk of virus transfer through the instruments both in the peri- and postoperative period. This can have several medical, administrative, and legal implications. Objectives: This document aimed to outline best practices that can be followed in this scenario to perform cutaneous surgeries and procedures to ensure safer skin surgery. Recommendations: Standard precautions include social distancing of at least 1 m, hand hygiene, appropriate use of personal protective equipment (PPE), safe injection practices, sterilization and disinfection of medical devices, environmental cleaning, and respiratory hygiene. It is generally advisable to see patients only by appointments. Each clinic should have a special area at entry for screening patients and providing sanitizers and masks. Procedures, which are of short duration, performed on nonfacial areas are considered as low risk and require donning surgical mask. Procedures involved with minimal invasiveness and bleeding, short duration procedures on the face such as injectables, chemical peels, and aerosol-generating procedures on nonfacial areas are considered moderate risk. These procedures need apron with head cover, N95 mask, face shield, double gloves, and smoke evacuator with high-efficiency particulate air (HEPA) or ultralow particulate air (ULPA) filter. Aerosol and plume-regenerating procedures (such as ablative lasers on the face), prolonged surgeries on head (such as hair transplantation), intraoral, and intranasal procedures are considered high risk. These procedures must be carried out with full body cover with surgical gown, head cover, N95 mask, face shield, double gloves, and smoke evacuator. Physicians should be aware of local epidemiological situation and adhere to the relevant guidelines issued by the relevant governmental agencies.


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