RESUMEN
BACKGROUND: At the onset of the COVID-19 pandemic, many Mohs micrographic surgeries (MMS) were delayed over concerns for propagating further infectious spread and scarcity of medical resources. OBJECTIVE: To assess the impact of the pandemic on MMS and the treatment of skin cancer Methods and Materials: An electronic survey was sent to fellowship trained Mohs surgeons to assess patient outcomes, practice viability, and physician sentiment related to performing MMS during the COVID-19 pandemic. RESULTS: Of the 303 respondents, 82% reported declines in case volume for at least 3 months, and average case difficulty increased for 69% of surgeons following these delays. Instances of local tumor spread following delays were seen by 69% of respondents, and 20% noted cases of regional or systemic metastasis. Only 8 cases of staff testing positive (and 7 cases of patients) were reported, and 97% of respondents felt comfortable performing MMS during the pandemic. Private practice surgeons more often viewed practice restriction recommendations negatively initially (42% vs 26% in academics, P=0.03) and in hindsight (63% vs 36% in academics, P<0.001). CONCLUSIONS: Mohs surgeon’s ability to minimize spread of COVID-19 during routine patient care, alongside potential risks of delaying treatment of skin cancers, should be considered in future recommendations for patient care. J Drugs Dermatol. 2022;21(5):545-547. doi:10.36849/JDD.6189.
Asunto(s)
COVID-19 , Neoplasias Cutáneas , Cirujanos , COVID-19/epidemiología , Humanos , Cirugía de Mohs/métodos , Pandemias/prevención & control , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Encuestas y CuestionariosAsunto(s)
COVID-19 , Transmisión de Enfermedad Infecciosa/prevención & control , Control de Infecciones , Cirugía de Mohs , Neoplasias Cutáneas , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Cirugía de Mohs/efectos adversos , Cirugía de Mohs/métodos , Estadificación de Neoplasias , Psicooncología/métodos , Medición de Riesgo , Gestión de Riesgos/organización & administración , SARS-CoV-2 , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/psicología , Neoplasias Cutáneas/cirugía , Tiempo de Tratamiento , Reino Unido/epidemiologíaAsunto(s)
Máscaras/efectos adversos , Cirugía de Mohs/efectos adversos , Colgajos Quirúrgicos , Dehiscencia de la Herida Operatoria , Adenocarcinoma Sebáceo/cirugía , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles/instrumentación , Humanos , Masculino , Cirugía de Mohs/métodos , SARS-CoV-2 , Neoplasias de las Glándulas Sebáceas/cirugía , Colgajos Quirúrgicos/efectos adversos , Colgajos Quirúrgicos/irrigación sanguínea , Dehiscencia de la Herida Operatoria/etiología , Dehiscencia de la Herida Operatoria/prevención & control , Supervivencia TisularRESUMEN
Dermatologic surgeons are at increased risk of contracting SARS-COV-2. At time of writing, there is no published standard for the role of pre-operative testing or the use of smoke evacuators, and personal protective equipment (PPE) in dermatologic surgery. Risks and safety measures in otolaryngology, plastic surgery, and ophthalmology are discussed. In Mohs surgery, cases involving nasal or oral mucosa are highest risk for SARS-COV-2 transmission; pre-operative testing and N95 masks should be urgently prioritized for these cases. Other key safety recommendations include strict control of patient droplets and expanded pre-clinic screening. Dermatologic surgeons are encouraged to advocate for appropriate pre-operative tests, smoke evacuators, and PPE. Future directions would include national consensus guidelines with continued refinement of safety protocols.