Table 2.

Cleft Surgery Safety Measures That Were Routine Before COVID-19 and Specific Adaptations for Consideration During and After COVID-19.

Period	Routine pre-COVID-19 safety measures	Suggested adaptations during and after COVID-19
Presurgical	Pre-op review by surgeon and anesthetist	Monitoring regional COVID prevalence
	Vital signs and weight	Virtual screening pre-op
	Blood tests	Consider the need for pre-op isolation
		COVID-19 vaccination status for patients and staff
		Patient testing with RT-PCR
		Staff testing with RT-PCR
		Protocol if COVID-19 positive
Peri-surgical	Multidisciplinary care by trained professionals	Allow for time delays due to COVID-19 precautions
	Appropriate pediatric medical and surgical facilities with adequate equipment and access to high dependency care	Skills and equipment to care for COVID-19 positive patients and staff
	Hygiene and running water	Isolation and quarantine facilities
	PPE for operating theater staff	PPE for all staff, patients and families
	Crisis notification plan	Distancing measures within facility
	Emergency arrest protocol	Consent to include COVID risk
	Pediatric anesthetic services	Minimize family members to reduce people at risk
	Informed consent process
	Safeguarding procedures for vulnerable people
	WHO surgical checklist
Postsurgical	Immediate postoperative pathways and observation
	Weigh risk/benefit for inpatient versus outpatient care
	Weigh risk/benefit for physical versus virtual follow-up
	Recording of outcomes and ongoing monitoring