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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2021; 06(02): e79-e86
DOI: 10.1055/s-0041-1736420
Original Article

Oncologic Head and Neck Reconstructive Microsurgery during the COVID-19 Pandemic in Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia

Dewi Aisiyah Mukarramah
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
,
Irena Sakura Rini
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
,
Rian Fabian Sofyan
2   Department of Surgical Oncology, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
,
Muhammad Irsyad Kiat
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
,
Iskandar Iskandar
2   Department of Surgical Oncology, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
,
Azmi Ritana
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
,
Bayu Brahma
2   Department of Surgical Oncology, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia
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Abstract

Background Head and neck cancer is one of the leading cancers worldwide. Complex head and neck procedures are potentially aerosol-generating and considered high risk for coronavirus disease 2019 (COVID-19) transmission between the patients, surgeons, and other health-care workers (HCWs). Several adjustments in the microsurgery procedure were needed. The COVID-19 protocol was developed and applied to minimize the COVID-19 transmission. The study objectives were to describe the preoperative, intraoperative, and postoperative protocols applied and the characteristics of patients who underwent head and neck reconstructive microsurgery during the COVID-19 pandemic in Dharmais Cancer Hospital-National Cancer Center.

Methods This study was a retrospective descriptive study of patients who underwent head and neck reconstructive microsurgery between March 2020 and December 2020 in the plastic surgery department and surgical oncology department, Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia. The patients' characteristics including sex, age, location of the defects, the flap type, flap survival, and complications were obtained from medical records and analyzed using SPSS version 23.

Results There were 55 patients, 30 (54.54%) patients were female, and 25 (45.45%) patients were male. The mean age at the time of surgery was 51.32 ± 1.85 years. The most common cancer type was squamous cell carcinoma for 49.09% (n = 27/55). The most frequent location was tongue for 25.45% (n = 14/55). Anterolateral thigh flap was also the most used flap in this study for 50.91% (n = 14/55). The overall survival rate of this study was 83.64% (n = 46/55). There were nine patients (16.36%) who were found with postoperative complications. There was no nosocomial infection with COVID-19 for patients, surgeons, and other HCWs.

Conclusion Microsurgery can be performed even in the COVID-19 pandemic as the gold standard for oncologic head and neck reconstruction by applying protocols to protect the patients, surgeons, and other HCWs.

Keywords

head and neck reconstruction - microsurgery - free flap - COVID-19 pandemic


Publication History

Received: 21 April 2021

Accepted: 22 June 2021

Article published online:
18 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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