Head and neck reconstruction in the SARS-CoV-2 pandemic era: outcomes and lessons learned

The COVID-19 pandemic is having a significant impact on the provision of non-COVID-19 related clinical services. Early recommendations for head and neck reconstructive surgery were based on guidance from expert groups, advocating de-intensification of surgery. Since then, patient outcomes derived data has suggested that the continued practice of head and neck reconstructive surgery based upon pre-pandemic standard of care is safe if appropriate measures are in place for appropriate screening and segregation of care pathways for patients. In addition, adequate levels of personal protective equipment (PPE) are vital for both patients and the healthcare team. We present the current practice guidance within the UK National Health Service (NHS) for head and neck reconstructive surgery in the COVID-19 pandemic era in the following areas: COVID-19 testing/screening, care pathways for patients, the potential future role of immunisation against SARS-CoV-2, airway management, selection of the type of reconstruction, postoperative care and rehabilitation. The guidance produced reflect the evolving nature of the response of NHS to the COVID-19 pandemic, some of the suggested practice protocols could differ from local policies in various parts of the world however the principles which underlie these standards are the results of regular review of the needs of the patients and health service, balanced against the background of the ebb and flow of the prevalence of COVID-19 infection within the community and healthcare settings.