Higuchi Shinichi, Hashikawa Kazunobu, Ebisawa Katsumi, Kambe Miki, Kamei Yuzuru
Department ofPlastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2024 Aug;86(3):472-478. doi: 10.18999/nagjms.86.3.472.
High perioperative mortality and complication rates during the coronavirus disease 2019 (COVID-19) pandemic have been reported. In head and neck reconstruction, not only is patient safety important, but the prevention of infection introduced by the surgical team is also important because the procedure is performed in close proximity to the upper respiratory tract. In addition, recent studies have reported an increased risk for thrombus formation after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 vaccination, which is problematic for microsurgical reconstruction procedures. At the authors' institution, patients undergoing head and neck reconstruction are requested to stay home for 2 weeks and undergo screening tests for COVID-19 before admission. Surgeons use standard personal protective equipment during surgery. There was no significant difference in the rate of total flap necrosis between the COVID-19 and non-pandemic periods or large difference of perioperative complication rates between vaccinated and non-vaccinated patients. No surgery-related infections among the surgical staff were also found.
据报道，2019冠状病毒病（COVID-19）大流行期间围手术期死亡率和并发症发生率较高。在头颈重建手术中，不仅患者安全很重要，而且由于手术操作靠近上呼吸道，防止手术团队引入感染也很重要。此外，最近的研究报告称，感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）或接种COVID-19疫苗后血栓形成风险增加，这对显微外科重建手术来说是个问题。在作者所在机构，接受头颈重建手术的患者被要求在入院前居家2周并接受COVID-19筛查测试。外科医生在手术期间使用标准的个人防护装备。COVID-19时期和非大流行时期之间皮瓣完全坏死率没有显著差异，接种疫苗和未接种疫苗的患者围手术期并发症发生率也没有很大差异。手术人员中也未发现与手术相关的感染。
