Department of Oral and Maxillofacial Surgery, Nottingham University Hospital, Derby Road, Nottingham, NG7 2UH, United Kingdom.
Surgeon. 2021 Oct;19(5):e276-e280. doi: 10.1016/j.surge.2020.12.010. Epub 2021 Jan 22.
The impact on the provision of care within the NHS due to COVID-19 can not be understated. It has created various challenges for Oral and Maxillofacial Surgeons due to the high-risk nature of working within this specialty. The aims of this study were to identify the ongoing clinical activities at the height of pandemic, the guidance issued to staff regarding the use of personal protective equipment and the changes to maxillofacial practice. A prospective analysis was commenced within six Oral and Maxillofacial Surgery units in the East Midlands, UK with data being collected by means of a 10-item questionnaire relating to changes in patient care during this time. The responses were analysed to identify compliance with the national guidance produced by the British Association of Oral and Maxillofacial Surgeons. An 87% response rate was obtained (26 respondents from 30 invitations). 73.1% of participants confirmed all surgical members of staff were offered fit tests for FFP3 masks. All units reported a continuation of Head and Neck cancer and emergency operations with a complete reduction in TMJ and orthognathic surgery. FFP3 masks were the most popular masks used for theatre activity whilst FFP2 and surgical masks were more widely used for examining patients and performing procedures in the emergency department. Changes in maxillofacial practice included the use of local flaps compared to free flaps, use of intermaxillary fixation (IMF) where appropriate for craniofacial trauma and routine COVID-19 testing for all inpatients.
由于 COVID-19 的影响，国民保健制度（NHS）内的护理服务受到了严重影响。这对口腔颌面外科医生来说带来了各种挑战，因为在这个专业领域工作具有高风险性质。本研究旨在确定在大流行高峰期的持续临床活动、为员工提供的个人防护设备使用指南以及颌面外科实践的变化。在英国东米德兰兹的六个口腔颌面外科单位内进行了前瞻性分析，通过与在此期间患者护理变化相关的十个问题的问卷收集数据。通过分析这些回答来确定其是否符合英国口腔颌面外科医师协会制定的国家指南。调查收到了 30 份邀请中的 26 份回复，响应率为 87%。73.1%的参与者证实，所有手术工作人员都接受了 FFP3 口罩的适合性测试。所有单位均报告继续开展头颈部癌症和急症手术，同时完全减少了 TMJ 和正颌手术。FFP3 口罩是手术室活动中最常用的口罩，而 FFP2 和手术口罩则更广泛地用于检查患者和在急诊科进行手术。颌面外科实践的变化包括与游离皮瓣相比使用局部皮瓣、在适当情况下使用颅颌面创伤的颌间固定（IMF）以及对所有住院患者进行常规 COVID-19 检测。
