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COVID-19; Plastic Surgery; Telemedicine; Corona virus pandemic.
During the COVID-19 pandemic, surgical elective procedures were stopped in our plastic surgery unit. Limitations for consultations and for follow-up of previous surgical procedures were imposed in order to minimize the risk of contagion in waiting rooms and outpatient clinics. We have identified telemedicine as an alternative way to follow patients during the lockdown. Nevertheless, we have experienced different difficulties. We have not had the possibility to use a secure teleconferencing software. In our unit we had not technological devices. Surgeons in our department were not able to use remote video technology for patient management. Guidelines for an appropriate selection of patients which could be served via telemedicine had to be created. Telemedicine must be regulated by healthcare organizations for legal, ethical, medico-legal and risk management aspects. Even if we have experienced an important need to use telematic solutions during the COVID-19 lockdown, liability and risk management issues has greatly limited this possibility in our unit. The need of telemedicine in the time of COVID-19 pandemic has encouraged us to implement future virtual encounters in order to reduce unnecessary in-person visits by taking into consideration all legal, ethical and medico-legal aspects.
2. Starnoni, Marta MD; Baccarani, Alessio MD, FACS; Pappalardo, Marco MD; De Santis, Giorgio MD Management of Personal Protective Equipment in Plastic Surgery in the Era of Coronavirus Disease, Plastic and Reconstructive Surgery - Global Open: May 2020 - Volume 8 - Issue 5 - p e2879 doi: 10.1097/GOX.0000000000002879
3. Starnoni M, Baccarani A, Pinelli M, Pedone A, De Santis G. Tattooing of the nipple-areola complex: What not to do. A case series. Ann Med Surg (Lond). 2020;55:305-307. Published 2020 May 30. doi:10.1016/j.amsu.2020.05.041
4. Starnoni M, Pinelli M, Franceschini G, De Santis G. A Rare Case of Nipple-Areolar Complex Partial Necrosis following Micropigmentation: What to Learn?. Plast Reconstr Surg Glob Open. 2019;7(11):e2494. Published 2019 Nov 27. doi:10.1097/GOX.0000000000002494
5. Baccarani A, Starnoni M, De Santis G. Ultrasonic Cutting and Coagulating Device in Implant-based Breast Reconstruction. Plast Reconstr Surg Glob Open. 2018;6(11):e2020. Published 2018 Nov 1. doi:10.1097/GOX.0000000000002020
6. Starnoni M, De Santis G, Pinelli M. Fibula Free Flap Elevation without Tourniquet: Are Harmonic Scalpel Shears Useful?. Plast Reconstr Surg Glob Open. 2019;7(9):e2409. Published 2019 Sep 10. doi:10.1097/GOX.0000000000002409
7. Pinelli M., Starnoni, M., De Santis, G. (2020). The Use of Cold Atmospheric Plasma Device in Flap Elevation. Plastic and Reconstructive Surgery - Global Open. Publish Ahead of Print. 1. 10.1097/GOX.0000000000002815.
8. Benanti E, Starnoni M, Spaggiari A, Pinelli M, De Santis G. Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction. Indian J Plast Surg. 2019;52(2):166-170. doi:10.1055/s-0039-1693504
9. Spaggiari A, Benanti E, Starnoni M, Sala P, Baccarani A, Santis G. Lower Lip and Chin Reconstruction with Functional Myocutaneous Gracilis Flap. Indian J Plast Surg. 2019;52(2):242-245. doi:10.1055/s-0039-1693511
10. Baccarani A, Starnoni M, Zaccaria G, et al. Obturator Nerve Split for Gracilis Free-flap Double Reinnervation in Facial Paralysis. Plast Reconstr Surg Glob Open. 2019;7(6):e2106. Published 2019 Jun 19. doi:10.1097/GOX.0000000000002106
11. Starnoni M, Pinelli M, De Santis G. Surgical Wound Infections in Plastic Surgery: Simplified, Practical, and Standardized Selection of High-risk Patients. Plast Reconstr Surg Glob Open. 2019;7(4):e2202. Published 2019 Apr 23. doi:10.1097/GOX.00000000000
12. Starnoni M., Colzani G., De Santis G., Leti Acciaro A.. Management of locked volar radio-ulnar joint dislocation. Plast Reconstr Surg Glob Open. 2019. 7(10):e2480.
13. Starnoni M., Colzani G., De Santis G., Leti Acciaro A.. Median nerve injury caused by screw malpositioning in percutaneous scaphoid fracture fixation. Plast Reconstr Surg Glob Open. 2019. 7(6):e2292.
14. Loeb AE, Rao SS, Ficke JR, Morris CD, Riley LH 3rd, Levin AS. Departmental Experience and Lessons Learned With Accelerated Introduction of Telemedicine During the COVID-19 Crisis. J Am Acad Orthop Surg. 2020;28(11):e469-e476. doi:10.5435/JAAOS-D-20-00380
15. Kim DW, Choi JY, Han KH. Risk management-based security evaluation model for telemedicine systems. BMC Med Inform Decis Mak. 2020;20(1):106. Published 2020 Jun 10. doi:10.1186/s12911-020-01145-7
16. Ray I, Poolsapassit N. Using attack trees to identify malicious attacks from authorized insiders. In: di Vimercati SC, Syverson P, Gollmann D, editors. Computer security – ESORICS 2005. ESORICS 2005. Lecture notes in computer science. Berlin: Springer; 2005. pp. 231–246.
17. Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid-19. N Engl J Med. 2020. 10.1056/NEJMp2003539.
18. Alloghani M, Al-Jumeily D, Hussain A, Aljaaf AJ, Mustafina J, Petrov E. Healthcare services innovations based on the state of the art technology trend Industry 4.0. In: 2018 11th Int Conf developments in n eSystems engineering (DeSE), vol. 2018. Cambridge. p. 64–70. 10.1109/DeSE.2018.00016.
19. Camara C, Peris-Lopez P, Tapiador JE. Security and privacy issues in implantable medical devices: a comprehensive survey. J Biomed Inf. 2015;55:272–289. doi: 10.1016/j.jbi.2015.04.007.
20. Al-Janabi S, Rawat S, Patel A, AlShourbaji I. Design and evaluation of a hybrid system for detection and prediction of faults in electrical transformers. Int J Electr Power Energy Syst. 2015;67. 10.1016/j.ijepes.2014.12.005.
21. Mahdi M, Al-Janabi S. International conference on big data and networks technologies. Cham: Springer; 2019. A novel software to improve healthcare base on predictive analytics and mobile services for cloud data centers; pp. 320–339
22. Department of Health and Human Services, USA. 2020. https://www.hhs.gov/sites/default/files/covid-19-hipaa-and-first-responders-508.pdf [Accessibility verified April 6, 2020].
23. Department of Health and Human Services, USA. BULLETIN: HIPAA Privacy and Novel Coronavirus. 2020. https://www.hhs.gov/sites/default/files/february-2020-hipaa-and-novel-coronavirus.pdf[Accessibility verified April 6, 2020].
24. Calton B., Abedini N., Fratkin M. Telemedicine in the time of coronavirus. J Pain Symp Manage. 2020 doi: 10.1016/j.jpainsymman.2020.03.019. S0885-3924(20)30170-6 [published online ahead of print, 2020 Mar 31] [PMC free article] [PubMed] [CrossRef] [Google Scholar]