Re: Orthognathic surgery in COVID-19 times, is it safe?

Sir,

We read with interest the paper by Glen et al. They undertook orthognathic surgery at a non NHS hospital following strict protocols and demonstrated that this can be done safely. Nevertheless, such ‘off site’ hospitals do not generally treat COVID patients and hence the risk of hospital acquired COVID infection is less. During the pandemic up to 1 in 4 patients may have acquired COVID whilst in NHS hospitals for other reasons.

At North West Anglia NHS Foundation Trust, from 29 July to 30 November 2020 we undertook 12 single jaw osteotomies following similar protocols to Glen et al. However, the patients’ length of preoperative isolation was 72 hours (h) from the time of their PCR test, and there was no routine asymptomatic staff testing. We also placed an emphasis on thoroughly consenting patients, and minimising inpatient length of stay. In addition, attendance at the hospital by visitors or accompanying personnel was severely restricted. Unlike the previously reported study, our NHS hospital continued to treat COVID patients in segregated areas during the whole pandemic.

All 12 treated patients were in hospital for one night only and had no COVID or other complications. Only single jaw osteotomies were done so as to minimise the inpatient stay, and also minimise the need for any emergency intensive care unit support that may occasionally be required with bimaxillary surgery.

One additional osteotomy patient, who had no COVID symptoms, was cancelled due to a positive PCR test.

We agree with the conclusions of Glen et al. We would add, from our experience that single jaw orthognathic surgery can be safely done at a COVID treating NHS hospital, providing strict protocols, and segregation of hospital COVID areas are adhered to, and inpatient stay is minimised.

Conflict of interest

We have no conflicts of interest.

Ethics statement/conformation of patients’ permission

Not required.