Impact of COVID 19 on Surgical Practices among Maxillofacial Surgeons of Nepal

Introduction: Oral and maxillofacial surgeons come into contact with the saliva, mucus, blood during the examination of patients. Coronavirus disease (COVID-19) is believed to spread primarily via respiratory droplets that put oral and maxillofacial surgeons at high risk of contracting the infection. COVID 19 has led to changes in maxillofacial surgical practices. There is a gap in knowledge regarding its real impact. So, we conducted this study with the objective to evaluate the impact of COVID-19 on maxillofacial surgery practices in Nepal. Methods: A web-based cross-sectional study was conducted among all the members of the Nepalese Association of oral and maxillofacial surgeons (NAOMS) practicing in Nepal. The survey was conducted from 25 June 2020 to 25 July 2020. The total enumeration sampling was used to collect information and 46 study participants enrolled in the study. A semi-structured questionnaire was developed and sent to study participants through a google form. Ethical clearance was taken from the Institutional Review Committee of Birat Medical College and Teaching Hospital and informed web-based consent was taken from study participants. Results: Only 46 participated among 70 invitations, with a response rate of 65.71%. Among the study participants, the majority (n=35, 76.08%) used personal protective equipment (PPE) for minor procedures and in the operating room. Most surgeons (n=37, 80.43%) asked to test their patients for COVID-19 prior to shifting to the Operating room. More than half of Surgeons were doing both elective and emergency surgeries (n=24, 52.17%). Almost all surgeons (n=44, 95.65%) responded that they have minimized aerosol-generating procedures. Almost two-thirds of surgeons (n=29, 63.04%) did not feel safe while working in a hospital. Conclusion: Despite the use of PPE by the majority of Maxillofacial Surgeons and asking their patients for the COVID- 19 test, they still did not feel safe to work at the hospital