Current Approach for Oral and Maxillofacial Surgery Interventions During COVID-19 Pandemic

Year 2020, Volume: 6 Issue: 2, 42 - 49, 26.08.2020

Koray Onur Şanal

Abstract

COVID-19 pandemic is a problem that closely concerns oral and maxillofacial surgery. The aim of this review is to guide healthcare workers by providing a perspective on the maintenance of oral and maxillofacial surgery patients during pandemic. The keywords of coronavirus disease, COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transmission, pandemic, oral surgery, personal protective equipment were searched on electronic databases (Google Academic, Pubmed, ScienceDirect, and Turkish Ministry of Health), until 11 July 2020. Literature search was conducted in English and Turkish languages. Health care workers accounted for 1/3 of the cases in China in the early period of the pandemic. It was necessary to postpone many elective procedures and give priority to emergency treatments in oral and maxillofacial surgery applications in our country and in the world. Healthcare providers should quickly identify emergency response procedures during outbreak. Thus, excessive load and waste of resources on the health system can be prevented. Infection control policies should be determined to prevent cross infections between inpatients and outpatients. The capacity of COVID-19 to spread rapidly through droplets necessitates the correct use of personal protective equipment. It is necessary to avoid the aerosol-generating procedures, but if these procedures are necessary, isolation of the environment should be provided. It is important that the guides used in the management of the problems that may be unique to oral and maxillofacial surgery do not conflict with the applications of other disciplines. Each healthcare institution should create flexible models that it can implement within its own means, in the transition period to elective procedures. Necessary policies should be used for the continuity of personal protective equipment. During the epidemic, collaborations should be established between different health institutions. Negative pressure rooms are recommended in elective surgeries. When planning elective surgeries during the gradual reopening process, short-term treatments should be considered against the possibility of a second wave. Every effort should be made to perform elective surgical procedures without causing any transmissions.

Keywords

Transmission, COVID-19, Personal protective equipment, Maxillofacial surgery, SARS-CoV-2

COVID-19 Pandemisinde Oral ve Maksillofasiyal Cerrahi Uygulamalarına Güncel Bakış

Abstract

COVID-19 pandemisi, yayılımının öncelikle solunum bölgesinden kaynaklanması sebebiyle oral ve maksillofasiyal cerrahiyi yakından ilgilendiren bir sorundur. Bu derlemenin amacı, pandemi sürecinde oral ve maksillofasiyal cerrahi hastalarının idamesine yönelik bir bakış açısı sağlayarak sağlık çalışanlarına bir rehber sunmaktır. Google Akademik, Pubmed, ScienceDirect elektronik veri tabanları ile Sağlık Bakanlığı ait verilerin koronavirüs hastalığı, COVID-19, şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2), bulaşma, pandemi, oral cerrahi, kişisel koruyucu ekipman anahtar kelimeleri Türkçe ve İngilizce 11 Temmuz 2020 tarihine kadar tarandı. Pandeminin erken döneminde Çin’deki vakaların üçte birini sağlık çalışanları oluşturmaktaydı. Ülkemizde ve Dünya’da oral ve maksillofasiyal cerrahi uygulamalarında birçok elektif prosedürlerin ertelenmesi, acil tedavilere öncelik verilmesi gerekmiştir. Pandemi sırasında sağlık sunucuları süratle acil müdahale prosedürlerini tanımlamalıdır. Böylece sağlık sistemi üzerinde oluşabilecek aşırı yükün ve kaynak israfının önüne geçilebilir. Serviste yatan hastalar ile ayaktan tedavi gören hastalar arasında çapraz enfeksiyonların önüne geçebilmek için enfeksiyon kontrol önlemleri belirlenmelidir. COVID-19’un damlacık yoluyla hızla yayılma kabiliyeti kişisel koruyucu ekipmanların doğru kullanımını zorunlu kılmaktadır. Aerosol üreten prosedürlerden kaçınmak gerekir ancak bu işlemlerin uygulanma zorunluluğu varsa ortamın izolasyonu sağlanmalıdır. Oral ve maksillofasiyal cerrahiye özgü sorunların yönetiminde kullanılan kılavuzların diğer disiplinlerin uygulamalarıyla çelişmemesi önemlidir. Elektif işlemlere geçiş döneminde, her sağlık kuruluşu kendi imkanları çerçevesinde uygulayabileceği esnek modeller oluşturmalıdır. Kişisel koruyucu ekipman sürekliliği konusunda gerekli önlemler alınmalıdır. Salgın döneminde farklı sağlık kurumları arasında iş birlikleri oluşturulmalıdır. Elektif cerrahilerde negatif basınçlı odaların kullanımı önerilir. Kademeli yeniden açılma sürecinde elektif cerrahileri planlarken ikinci bir dalga ihtimaline karşı kısa vadeli tedaviler düşünülmelidir. Elektif cerrahi işlemlerin bulaşa neden olmadan gerçekleştirilebilmesi için her türlü çaba gösterilmedir.

Keywords

bulaşma, COVID-19, Kişisel koruyucu ekipman, Maksillofasiyal cerrahi, SARS-CoV-2

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