key: cord-0898443-s9hi18oq
authors: Maciel-Miranda, Alejandro; Escrivá-Machado, Jesus Francisco; García-González, Luis Alberto; Cortés-Flores, Ana Olivia
title: Breast Reconstruction for Cancer Patients in COVID-19 Pandemic
date: 2021-07-09
journal: Plast Reconstr Surg
DOI: 10.1097/prs.0000000000008115
sha: 8015a9b56bd436d9474180f33de93d51c2de1d02
doc_id: 898443
cord_uid: s9hi18oq

nan

surgical procedures to reduce patient exposure to coronavirus. We even try to favor a same-day surgery approach. This could mean direct-to-implant surgery when feasible or tissue expander placement when a second surgery would be required. We also look for options that reduce patient hospital stay, such as enhanced recovery after surgery protocols; combined anesthesia, with local blockades to reduce the effects of intravenous medications (e.g., nausea and vomiting) to favor shorter hospital stays; and oral intubation to contain aerosolization of virus for the protection of the surgical team. 3 Immediate reconstruction will favor less exposure to coronavirus, avoiding at least one subsequent surgery and hospitalization.

There have been reports of thrombosis complications secondary to coronavirus infection. 4 In this scenario, microsurgery procedures could be delayed until we have more and better knowledge, or at least new data and evidence of perioperative complications in elective microsurgery procedures. When the possibility of radiation was present, or after a shared decisionmaking approach, we opted for microsurgical free flap reconstruction, a tissue expander would be a better option to delay flap surgery at least 6 months, so we can offer a better safety profile. Offering immediate lymphatic reconstruction would offer higher benefits in these circumstances, to avoid new surgical procedures when possible, in addition to its established benefits. 5 Nowadays, coronavirus infection considerations should be part of the shared decision-making process, and first consultation could be performed through virtual online options and three-dimensional models, as well as some follow-up consultations. Breast reconstruction should be considered in breast cancer patients even during the actual COVID-19 pandemic, and time will tell which is the best approach. For now, we should be proactive with caution. 

Ohio Coalition for the Education of Children with Disabilities. For Parents. Marion, Ohio: Ohio Coalition for the Education of Children with Disabilities

OCHA and AAP face coverings masking guidelines

Cleft and COVID-19. London: Cleft Lip and Palate Association

A war on two fronts: Cancer care in the time of COVID-19

A study on breast reconstruction in a developing country: A comprehensive evaluation of the techniques and oncologic outcomes

Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: Systematic review and meta-analysis of the literature

COVID-19 and its implications for thrombosis and anticoagulation

Is immediate lymphatic reconstruction cost-effective? Ann Surg

The authors have no financial interest to declare in relation to the content of this article.

The authors have no financial interest to declare in relation to the content of this article.