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Plast Reconstr Surg ; 148(1): 133e-139e, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1284960

ABSTRACT

SUMMARY: The coronavirus disease of 2019 pandemic became a global threat in a matter of weeks, with its future implications yet to be defined. New York City was swiftly declared the epicenter of the pandemic in the United States as case numbers grew exponentially in a matter of days, quickly threatening to overwhelm the capacity of the health care system. This burgeoning crisis led practitioners across specialties to adapt and mobilize rapidly. Plastic surgeons and trainees within the New York University Langone Health system faced uncertainty in terms of future practice, in addition to immediate and long-term effects on undergraduate and graduate medical education. The administration remained vigilant and adaptive, enacting departmental policies prioritizing safety and productivity, with early deployment of faculty for clinical support at the front lines. The authors anticipate that this pandemic will have far-reaching effects on the future of plastic surgery education, trends in the pursuit of elective surgical procedures, and considerable consequences for certain research endeavors. Undoubtedly, there will be substantial impact on the physical and mental well-being of health care practitioners across specialties. Coordinated efforts and clear lines of communication between the Department of Plastic Surgery and its faculty and trainees allowed a concerted effort toward the immediate challenge of tempering the spread of coronavirus disease of 2019 and preserving structure and throughput for education and research. Adaptation and creativity have ultimately allowed for early rebooting of in-person clinical and surgical practice. The authors present their coordinated efforts and lessons gleaned from their experience to inform their community's preparedness as this formidable challenge evolves.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/standards , Pandemics/prevention & control , Surgery, Plastic/trends , Academic Medical Centers/standards , Academic Medical Centers/statistics & numerical data , Academic Medical Centers/trends , COVID-19/prevention & control , COVID-19/transmission , Education, Medical, Graduate/organization & administration , Education, Medical, Graduate/standards , Education, Medical, Graduate/trends , Elective Surgical Procedures/education , Elective Surgical Procedures/standards , Elective Surgical Procedures/trends , Faculty/organization & administration , Faculty/psychology , Faculty/statistics & numerical data , Forecasting , Humans , Internship and Residency/statistics & numerical data , New York City/epidemiology , Personnel Staffing and Scheduling/organization & administration , Personnel Staffing and Scheduling/trends , Plastic Surgery Procedures/education , Plastic Surgery Procedures/standards , Plastic Surgery Procedures/trends , Surgeons/organization & administration , Surgeons/psychology , Surgeons/statistics & numerical data , Surgery, Plastic/education , Surgery, Plastic/organization & administration , Surgery, Plastic/standards , Surveys and Questionnaires/statistics & numerical data , Uncertainty , Universities/standards , Universities/statistics & numerical data , Universities/trends
4.
Plast Reconstr Surg Glob Open ; 9(5): e3586, 2021 May.
Article in English | MEDLINE | ID: covidwho-1243549

ABSTRACT

Over the past 15 years, landmark achievements have established facial transplantation (FT) as a feasible reconstructive option for otherwise irreparable craniofacial defects. However, as the field matures and long-term outcomes begin to emerge, FT teams around the world are now facing new challenges. Data for this review were identified by searches of the PubMed/MEDLINE database from inception through August 2020. All English-language articles pertaining to FT were included. Significant advances in candidate selection, technology, operative technique, posttransplant care, and immunosuppressive management have contributed to the tremendous expansion of the field, culminating in the execution in the past 3 years of 2 facial re-transplantations, and most recently the world's first successful combined face and double hand transplant in August 2020. Despite these achievements, the allograft donor pool remains limited, with long wait times, requiring surgical experimentation with cross-sex FT. Immunosuppressive management has improved, but significant adverse events continue to be reported. Most recently, the COVID-19 pandemic has placed an unprecedented strain on the healthcare system, with various implications for the practice of reconstructive transplantation. In this article, we provide the most comprehensive and up-to-date FT review, highlighting fundamental lessons learned and recent advancements, while looking toward the challenges ahead. Over the past 15 years, extensive multidisciplinary efforts have been instrumental to the establishment of FT as a feasible reconstructive option. As novel challenges are beginning to emerge, continued collaborative and multispecialty research efforts are needed to further this field.

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