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Guidelines for maxillofacial surgeon concerning emergency operative procedures in COVID-19 outbreak

The COVID-19 pandemic is now a global problem that has significantly impacted the safe practice of Maxillofacial Surgery. It is important to compile information and experiences that have been gained worldwide and define a set of guidelines for best practice for staff performing these procedures and for patients undergoing maxillofacial surgery procedures. As such, these recommendations should be treated as “expert opinion” and are based mostly on personal communication, guidelines put forth by various national and international societies, and peer-reviewed data when possible. Surgical procedures involving the nasal–oral–endotracheal mucosal region are high risk due to aerosolization of the virus, which is known to be in high concentration in these areas when compared to swabs from the lower respiratory tract1. Further, it appears that if viral particles become aerosolized, they stay in the air for at least 3 h, if not longer. Based on experience in Wuhan, China, and Northern Italy, N95 masks were not enough to control this spread of the disease and it was not until powered air-purifying respirators were introduced that transmission of the virus was controlled among medical personnel. The current paper focuses on setting basic guidelines for dental operating surgeons in taking up an emergency operative procedure.