The Impact of COVID-19 on the Personal Protective Equipment Practices and Preferences of Craniofacial Surgeons

BACKGROUND: The COVID-19 pandemic has raised concern about healthcare worker exposure risk. Surgeons operating near the aerodigestive tract are at particularly high risk, given the respiratory spread of SARS-CoV-2. This study examines the practices and opinions of craniofacial surgeons as they adapt to a worldwide epidemic. METHODS: An electronic survey study was conducted on practicing craniomaxillofacial surgeons regarding their preference of personal protective equipment use before, during, and after the pandemic in patients with or without COVID-19 infection, as well as demographic data. Statistical analysis was performed to compare changes in behaviors and preferences and differences across demographic groups. RESULTS: Craniofacial surgeons changed their behaviors significantly during the pandemic, with 91.5% of respondents wearing N95 masks or powered air purifying respirators for operations involving exposure of the nasal or oral airways on untested patients, compared with 4.3% before the pandemic (P < 0.001). For examinations in the clinic, 100% reported wearing a mask during the pandemic compared with 40.3% before the pandemic (P < 0.001). After the pandemic is over, 31.9% of surgeons planned to continue using an N95 mask or powered air purifying respirator for craniomaxillofacial cases and 80.9% planned to continue using masks in clinic. Overall, 46.8% of respondents believed that N95 masks should be the standard for craniofacial surgery. CONCLUSIONS: The COVID-19 pandemic has significantly shifted the practices and opinion of craniofacial surgeons toward more protective personal protective equipment. These results indicate that this is likely to persist after the pandemic is over, which may limit surgeon exposure to airborne disease and help the field withstand future epidemic outbreaks.