Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY.
Oral and Maxillofacial Department, Bristol Dental Hospital, Lower Maudlin Street, BS1 2LY.
Br J Oral Maxillofac Surg. 2021 May;59(4):490-493. doi: 10.1016/j.bjoms.2021.01.005. Epub 2021 Jan 22.
COVID-19 has impacted the provision of orthognathic surgery globally. Uncertainty around its effects and transmission in aerosol generating procedures (AGP's) has led to disagreement within maxillofacial surgeons into the safety of orthognathic surgery during the pandemic. We present a local case series of orthognathic surgery undertaken during the COVID-19 pandemic. To our knowledge no such similar study has been reported worldwide. Data was collected from the 1 June to 30 November 2020 for all patients undergoing orthognathic surgery by a single consultant. All procedures and inpatient stays were performed 'off site' at the local Spire Healthcare Group plc© facility. A strict preoperative two-week self-isolation period and negative COVID-19 testing was mandatory. All procedures were classified as AGP's and personal protective equipment (PPE) was worn in line with local guidelines. The primary outcome was 30-day COVID-19 infection among patients, with day 0 the date of surgery. Secondary outcome measures included duration of stay, return to theatre and complications. A total of 59 patients were identified. 42/59 had bimaxillary procedures and 17/59 single jaw. 9/17 had maxillary and 8/17 had mandibular procedures. A total of 3/59 had simultaneous genioplasty. Median duration of stay was one night (range 1-3). Immediate and late complications were seen in 3% (2/59) and 3% (2/59) respectively. Only 1% (1/59) returned to theatre. Zero patients tested positive in the 30-day postoperative period. No staff members tested positive for the duration of the study. Adopting strict safety protocols, orthognathic surgery can be safely delivered during the pandemic without detriment to the patient or staff.
新冠疫情对全球正颌手术的开展产生了影响。由于对气溶胶生成操作（AGP）中该疾病的影响和传播存在不确定性，颌面外科医生对于大流行期间正颌手术的安全性存在分歧。我们展示了在新冠疫情期间进行的一系列局部正颌手术病例。据我们所知，目前全世界尚无类似的研究报告。该研究的数据收集时间为 2020 年 6 月 1 日至 11 月 30 日，涵盖了一位主治医生经手的所有正颌手术患者。所有手术和住院治疗均在当地斯皮尔医疗保健集团 plc©机构的“场外”地点进行。所有患者都必须严格执行术前两周的自我隔离期，并进行新冠病毒检测。所有手术均被归类为 AGP，并按照当地指南佩戴个人防护设备（PPE）。主要结果是患者在术后 30 天内感染新冠病毒，以手术日期为 0 天。次要结果指标包括住院时间、再次手术和并发症。共确定了 59 名患者。42/59 名患者行双颌手术，17/59 名患者行单颌手术。9/17 名患者行上颌手术，8/17 名患者行下颌手术。共有 3/59 名患者同时行颏成形术。中位住院时间为 1 晚（范围 1-3 晚）。分别有 3%（2/59）和 3%（2/59）的患者发生即时和迟发性并发症。仅 1%（1/59）的患者再次手术。在术后 30 天内，没有患者的新冠病毒检测结果呈阳性。在整个研究期间，没有工作人员的检测结果呈阳性。通过采取严格的安全措施，正颌手术可以在大流行期间安全进行，不会对患者或工作人员造成不利影响。
