Plastic Surgery and the COVID-19 Pandemic: A Review of Clinical Guidelines

Ann Plast Surg. 2020 Aug;85(2S Suppl 2):S155-S160. doi: 10.1097/SAP.0000000000002443.


Background: A novel coronavirus disease (COVID-19) was first reported in December 2019 in China and was soon declared a pandemic by the World Health Organization. Many elective and nonessential surgeries were postponed worldwide in an effort to minimize spread of disease, as well as to conserve resources. Our goal with this article is to review current practice guidelines in setting of the COVID-19 pandemic, based on available data and literature.

Methods: Websites pertaining to surgical and medical societies, and government agencies were reviewed, along with recently published literature to identify recommendations related to COVID-19 and plastic surgery procedures.

Results: Clinical practice modifications are recommended during the pandemic in outpatient and perioperative settings. Use of personal protective equipment is critical for aerosol-generating procedures, such as surgery in the head and neck area. Care for trauma and malignancy should continue during the pandemic; however, definitive reconstruction could be delayed for select cases. Specific recommendations were made for surgical treatment of cancer, trauma, and semiurgent reconstructive procedures based on available data and literature.

Conclusions: The risk and benefit of each reconstructive procedure should be carefully analyzed in relation to necessary patient care, minimized COVID-19 spread, protection of health care personnel, and utilization of resources. Recommendations in this article should be taken in the context of each institute's resources and prevalance of COVID-19 in the region. It should be emphasized that the guidelines provided are a snapshot of current practices and are subject to change as the pandemic continues to evolve.

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / transmission
  • Elective Surgical Procedures / methods
  • Elective Surgical Procedures / standards
  • Global Health
  • Health Care Rationing / methods
  • Health Care Rationing / standards
  • Health Services Accessibility / standards
  • Humans
  • Infection Control / methods
  • Infection Control / standards*
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Infectious Disease Transmission, Professional-to-Patient / prevention & control
  • Pandemics / prevention & control*
  • Perioperative Care / methods
  • Perioperative Care / standards*
  • Plastic Surgery Procedures / methods
  • Plastic Surgery Procedures / standards*
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / transmission
  • Practice Guidelines as Topic*
  • Risk Assessment
  • SARS-CoV-2