Considerations in Head and Neck Oncologic Reconstructions and Microsurgery During COVID-19 Pandemic
COVID outbreak has incapacitated the healthcare system around the world. Existing resources and manpower are being redirected to take care of the COVID-19 disease patients. People with head and neck cancers with the need of post ablative reconstruction are in difficult situation owing to multiple factors like poor general condition, disease progression and potential chance of getting an infection of COVID -19 in a health care facility as well as doubt regarding treatment completion i.e. adjuvant treatment. Appropriate reconstruction following ablative surgery, especially in advanced disease, facilitates functional recovery and thus adding to the quality of life of the patients.The reconstructive procedures are resource-intensive, requiring long hours of surgery, trained manpower, and multiple team members. However, if adequate surgical excision demands the reconstructive procedure, then it should not be a hindrance for the standard treatment. We need to review our approach in the face of the devastating COVID-19 pandemic. We are presently working in resource constraints like limited availability of staff and limited availability of personal protective equipment especially in plastic surgery procedures which requires the use of loupes and microscope. Thus, the challenge is to ensure proper reconstruction with limited available resources and maintaining safety standards for the staff in the operation theatre. This work is based on our experience and evidence from the literature.