Intraoperative modifications done to continue performing traumatic maxillofacial surgery during COVID-19 times

Abstract

Background: Operating on maxillofacial trauma cases in the severe acute respiratory syndrome coronavirus-2 disease 2019 (COVID-19) era comes with its own disadvantages to operating teams with the current standard operating protocol. Methods: We present the various modification in techniques we have devised in a step-wise manner to overcome these difficulties while operating in COVID-19 times. Twenty-eight cases of maxillofacial fracture were operated in a span of 1 COVID year, i.e., from March 2020 to February 2021. Intraoperative modifications were applied for the techniques of drilling, implants used associated with aerosol generation (AG). Results: Of the 28 cases that had undergone maxillofacial injury, 20 were mandible fractures, 6 are midface, 2 are upperface/midface and 1 upper face fracture, of the mandible fractures, 12 were single sites and 8 were fractures involving two sites. Conclusions: Using microplating with self-drilling screws appear to be the first choice for fixing mandible fractures in COVID times, reducing AG by decreasing the duration of drilling and containing the aerosol spread by an adequate protective barrier around the drill apparatus should be considered. Intraoperative stability of fracture fixation sites post-fixation with mini and microplate as individual and in combination was found to be helpful.

Keywords

• aerosol generation
• covid-19
• maxillofacial fracture
• self-drilling screws