COVID-19 and Plastic Surgery

COVID-19 and Plastic Surgery in Sydney

How is COVID-19 (Coronavirus) affecting plastic surgery in Sydney?

Coronavirus is changing the economic and social climate across Australia and the world. These are unprecedented times and the situation is evolving day by day, and week by week. As of 23rd March 2020, in Sydney, we are preparing to see a surge in Covid-19 pandemic cases across the city. Therefore our city, its care facilities, and its hospitals slowly go into lockdown.

At the time of writing this article, plastic surgery offices of most plastic surgeons are still open but that is about to change. Last week we were still performing surgery in the public and private health system sector although with some restrictions. However, both are likely to change by the end of this and next week.

This stage at Mode Plastic Surgery, we are only seeing URGENT consultations this week and early next week. We have made the difficult decision to almost completely stop our practice as of 1/4/20.

This will mean that until that time we are undertaking the following measures:

–       Strict handwashing or use of hand microbial gel for each patient, and staff member before and after any patient review

–       Strict wipe down of all surfaces between patients

–       Booking only URGENT consultations for new patients

–       Cancelling all non-essential follow up for patients (ie other than for drain or suture removal)

–       Cancelling our consulting at Chris O’Brien Lifehouse – this is our only consulting location within a hospital setting, and where patients share a common waiting room with other patients. Lifehouse is also across the road from RPA which is one of the major Coronavirus testing centres. To reduce exposure to the virus for our staff and patients, we have relocated this consulting to our other more private locations to increase social distance.

As of 1/4/20 :

·      We will not be conducting any private or public hospital lists as our hospitals will be faced with overwhelming demand

·      We will continue to see URGENT follow-ups in rooms ie those patients who are post-op and need drain or suture removal. We may see URGENT new referrals but these will be very restricted given that no hospital operating lists are going to be available for surgery.

·      We will have our office/ phones attended for 2 days a week only, at other times messages can be left on our voicemail and email. In case of emergency, private patients can contact Dr. Aggarwal on his mobile, and public patients may need to contact their GP. Or the plastics registrar on call at the hospital where they had their surgery.

·      At this stage, we do not know when our normal consulting and theatre lists will resume. The patients who had their consultations postponed this week, and those that may have contacted us will be contacted to schedule their appointment when it is safe to do so. This may occur in June or July (or later if things have not settled).

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How is COVID-19 (coronavirus) affecting plastic surgery in public hospitals?

Dr Aggarwal works at two major public and teaching hospitals in Sydney – Royal Prince Alfred and Prince of Wales/Royal Hospital for Women. RPAH has been designated as one of the key Coronavirus testing sites, although all public hospitals are running a Covid-19 check clinic.

Ultimately all public hospitals will be key in responding to the onslaught of coronavirus cases that NSW Health is predicting. These will require resources from all specialties and departments to be pooled to look after potentially sick patients on the ward, in ICU and possibly convert operating theatres to makeshift ICU beds.

In preparation for the possible catastrophic number of ill patients, our public hospitals have gone into lockdown. Cancelling all elective surgery (other than urgent cancer or trauma cases) to free up resources such as hospital beds, ICU beds, and operating theatres. RPAH took the decision 3 weeks ago to cancel all elective surgery, and Prince of Wales/Royal Hospital for Women has had to make the same decision last week.

The situation at both hospitals is unlikely to change until we are well past the coronavirus pandemic. Meaning many elective operations will be indefinitely postponed, and even more urgent things like skin cancer surgery may carry significant delays.


How is COVID-19 (coronavirus) affecting plastic surgery in private hospitals?

Last week and this week, the private sector is proceeding with activity as normal with very strict criteria on patients that have to be excluded from surgery (e.g. returning from overseas, ill-health or close contact of a COVID-19 patient).

However, this situation is likely to change by next week (commencing 30th March).  Dr. Aggarwal does a big part of his private operating lists at the Sydney Adventist Hospital, the largest private hospital in Sydney and New South Wales in general.

Given that the SAN has a significant infrastructure including ICU to manage sick patients it will be called upon by NSW Health, and the government to look after sick coronavirus patients needing ICU. Or alternatively performing urgent surgery lists from the public hospitals who may not have the capacity to do so. This is going to restrict private operating theatre time available to all the surgeons at the Sydney Adventist Hospital. We expect this to happen as early as 1st April 2020.

Currently, we are bringing forward patients due for urgent skin cancer surgery to this week and early next week, and anticipating that all lists as of 1st April will likely be cancelled. Any conditions or requests that are not pressingly urgent will be advised to wait for 3 to 6 months for their surgery.


Can I still have my skin cancer surgery during the COVID-19 (coronavirus) pandemic?

Unlikely. We are still consulting URGENT patients this week. However, due to the public and private hospital response in the health care system to the coronavirus, and general safety of the public we will not be doing any regular lists as of 1/4/20.


Can I still have my breast reconstruction surgery during the COVID-19 (coronavirus) pandemic?

Unlikely. We are still consulting URGENT patients at our clinic locations.

However due to the public hospital restrictions on what is allowed during the pandemic we are likely to only see breast cancer patients proceed to surgery. With all patients requesting prophylactic mastectomy and reconstructions placed on hold indefinitely. Even patients with breast cancer may face some delay in getting to surgery due to lack of theatre time in the public hospital and the need to coordinate breast and plastic, surgery teams.

In the private sector, theatre time is likely to be restricted as well due to overflow from the public sector, and also the ICU needing to look after coronavirus patients. The planning may be slightly easier in the private sector at the time of writing this article – 23rd March 2020.


Can I still have my cosmetic plastic surgery during the COVID-19 (coronavirus) pandemic?

No. We have had to make the decision for the safety of our patients and staff to postpone seeing new cosmetic patients until the pandemic has settled.

If you are a patient of ours, that had booked elective cosmetic surgery with us in the near future it is our opinion that anything that can wait until the situation settles, should. Our staff will be in contact this week to discuss postponing your elective surgery to 3 to 6 months later when hopefully the coronavirus situation is under control.


Which plastic surgeons’ offices are still open during the COVID-19 (coronavirus) pandemic?

Until last week Mode Plastic Surgery was hoping to stay open. But as of March 23rd, we have taken the difficult decision to wind down our practice until the coronavirus pandemic is over. After 1/4/20 we will move to very restrictive contact hours with patients, and run a virtual office for 2 days a week without patient contact.


What do I do in the case of an emergency and my plastic surgeon’s office is closed due to the COVID-19 (coronavirus) pandemic?

Mode Plastic Surgery will move to restricted opening hours as of 1/4/20 during the coronavirus pandemic. If it is not immediately urgent, you will be able to contact us via phone or email if you have any concerns but you may need to leave a message. If you are a private patient of Dr. Aggarwal’s you will also have his mobile number in case of any emergencies.

If we are closed, you will need to contact your GP. You could visit your local hospital emergency department – however, you should only do so in the case of an absolute emergency as they are likely to be attending to unwell coronavirus patients, and their resources will already be stretched.


Stay safe everyone.

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