key: cord-0964751-9khajz8p
authors: Bonavolontà, Paola; Troise, Stefania; Arena, Antonio; Abbate, Vincenzo; Califano, Luigi
title: The use of Personal Protective Equipment during the COVID-19 pandemic: the effects on surgical wounds healing after parotid gland surgery
date: 2021-10-07
journal: J Plast Reconstr Aesthet Surg
DOI: 10.1016/j.bjps.2021.09.005
sha: 838d284b2850daca338b0ea64475fd1820e57128
doc_id: 964751
cord_uid: 9khajz8p

During the COVID-19 pandemic, facemask wearing was an effective nonpharmacologic intervention to reduce the spread of the infection. However, many Authors have shown that the chronic use of masks is not without discomfort: the patients reported feel shortness of breath, feel discomfort in the ears due to the elastics, dermatitis/skin problems and esthetic issues. The aim of our study was to underline that the chronic use of mask in patients who underwent to parotid surgery for benign neoplasia with a preauricular approach, seems to retard the surgical wounds healing. We conducted a statistic comparison analysis between two groups of patients surgically treated before the pandemic and during the pandemic. The data obtained seem to confirm that the chronic use of the mask slows down wounds the healing of the parotid region after surgery for benign neoplasia.

During the COVID-19 pandemic, facemask wearing was an effective nonpharmacologic intervention to reduce the spread of the infection. However, many Authors have shown that the chronic use of masks is not without discomfort: the patients reported feel shortness of breath, feel discomfort in the ears due to the elastics, dermatitis/skin problems and esthetic issues. The aim of our study was to underline that the chronic use of mask in patients who underwent to parotid surgery for benign neoplasia with a preauricular approach, seems to retard the surgical wounds healing. We conducted a statistic comparison analysis between two groups of patients surgically treated before the pandemic and during the pandemic. The data obtained seem to confirm that the chronic use of the mask slows down wounds the healing of the parotid region after surgery for benign neoplasia. Commonly the wound healing consists in four overlapping stages: hemostasis, inflammation, proliferation and finally maturation and/or remodelling. In particular, during the angiogenesis and maturation phases, any trauma to the area of skin involved in surgery will lead to the destruction of the small and delicate sprouting vessels that repopulate the dermis with the result of dehiscence.

Any disruptions in healing such as infection or dehiscence itself will lead to a compromised wound that enters a stage of secondary healing, that is more prone to infection and pathological scarring 4 .

So, during the pandemic, we observed in the postoperative time a significant increase in dehiscence and inflammation of surgical wounds after parotid gland surgery for benign lesions. In fact we registered 13.75% cases of parotid region dehiscence after benign neoplasia surgery, compared with the literature data of 2-3% of cases 5 . We therefore hypothesized a possible correlation between the frictional trauma due to the loop of the masks and the delay of healing and dehiscence of the surgical wounds of parotid region. We recorded a total of 3 surgical wound dehiscences in group A and 11 in group B ( Table 1) .

The statistical analysis of the data was performed using a chi-square test (Microsoft Excel 16.16.27

Version) and comparing the obtained values with the chi-square standard distribution tables.

We thus obtained that the number of parotid regions dehiscences after surgery, obtained during the pandemic, is statistically higher than in the period preceding the covid-19 (chi-square value 6,81).

Thus we confirmed our hypothesis of correlation between the use of a mask and the parotid region dehiscence: we suggest to our patients to use the PPE with mask loop clips, or extenders, to avoid any frictional trauma that can retard healing wounds.

None declared.

Funding: None declared 

Evaluation, and Treatment of Coronavirus (COVID-19)

The Use of Facemasks During the COVID-19 Pandemic by the Brazilian Population

Review of surgical techniques and guide for decision making in the treatment of benign parotid tumors

Wound healing

Surgical site complications after parotid gland surgery for benign tumors in a centralized setting: A Clavien-Dindo class cohort analysis

None.