Availability of COVID-19 Information from National and International Aesthetic Surgery Society Websites

Abstract

Background

National and international aesthetic surgery society websites are an important source of information for patients and aesthetic surgeons. The current COVID-19 pandemic represents an unprecedented global health crisis. The aim of this study was to assess the information available on national and international aesthetic surgery society websites on the current pandemic of COVID-19.

Methods

National and international aesthetic surgery society websites were assessed with regard to COVID-19 information.

Results

Thirty-one per cent of nations had aesthetic surgery society websites. Twenty-two per cent of national society websites had a specific COVID-19 section. Seventeen per cent of these websites had COVID-19-specific guidelines available; of these websites with guidelines, 77% had a specific COVID-19 section advising to provide only urgent or emergent care and 46% provided their sovereign state’s directives to provide only urgent or emergent care. Two international aesthetic surgery society websites had COVID-19-specific guidelines, and one of the two had significant educational resources.

Conclusion

The availability of COVID-19 clinical guidelines and patient information sheets on national plastic surgery society websites is sparse. In contrast, one international society website carefully analysed national and international recommendations and guidelines and made general recommendations for its members with regularly updated resources. This study suggests that improvement and increase in COVID-19 information provided by many national aesthetic surgery society websites may be improved by links to the ISAPS website.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Introduction

The current COVID-19 pandemic represents an unprecedented global health crisis [1]. The World Health Organization (WHO) is urging countries to improve efforts to contain the disease and protect healthcare workers and notes that a solution calls for 'aggressive preparedness', all around the world [1, 2]. On 11 March 2020, the WHO officially declared COVID-19 a pandemic [2]. Healthcare systems around the world are operating at, or preparing to operate at, above usual capacity, and significant adjustments in surgical services will be required. It presents challenging choices about whether aesthetic surgical care can and should be delayed or reprioritized, with the immediate goal of minimizing exposure risk for frontline healthcare providers and vulnerable patients [2]. International healthcare systems have variable environments, with conditions differing significantly by locality [3, 4]. Critical decisions concerning the deployment of resources and the management of elective aesthetic surgical procedures should be made based on institutional policies and recommendations from local, national and international authorities, considering the availability of finite and essential resources [5, 6].

National and international aesthetic surgery societies are seen as trustworthy sources of information [7]. Their websites should provide clinical information, and guidelines need to meet national and international standards [7, 8]. To help aesthetic surgeons stay informed during this rapidly evolving situation, national and international aesthetic surgery societies may gather and evaluate COVID-19 resources, recommendations and guidelines from different countries and international organizations such as the World Health Organization (WHO), to provide materials that are more specific to aesthetic surgeons, including information for practice management with particular focus on patient and surgeon safety [7, 8]. No studies have assessed the information available on national and international aesthetic surgery society websites [9]. The aim of this study is to evaluate each national and international aesthetic surgery society websites for availability of COVID-19 information.

Methods

A Google search was performed of United Nations member sovereign states to determine whether they had a national aesthetic surgery society website and to assess its contents [10]. The name of the society had to contain the words 'aesthetic and/or cosmetic' and 'surgery' in its title. The Google search engine has the search terms ‘aesthetic surgery’ or ‘cosmetic surgery’ and ‘society OR association’ and ‘(Name of nation of interest)’. Each website was assessed for the presence of a COVID-19 information, clinical practice guidelines and links. In addition, International Society of Aesthetic Plastic Surgery (ISAPS) and all national and international ISAPS Global Alliance Participating Societies were included [11]. All national and international societies associated with the European Association of Society of Aesthetic Plastic Surgery were also included [12]. This was performed on 31 March 2020. The presence of COVID-19 information was recorded.

Results

There are 193 United Nations member sovereign states. Sixty-five (31%) of United Nations member sovereign states had at least one national aesthetic surgery society. Eight sovereign states had two national ISAPS Global Alliance Participating Societies. Seventy-seven (39%) of national aesthetic surgery societies had a website. COVID-19 was mentioned in 13/77 (17%) of those national plastic surgery society websites, of which 10/13 (77%) of societies advised to provide only urgent or emergent care. Six of thirteen (46%) provided their state’s directives to provide only urgent or emergent care, and 1/13 (8%) recommended following World Health Organization guidelines.

All five aesthetic surgery international societies had a website. COVID-19 was mentioned in 2/5 (40%) of those international plastic surgery society websites, of which 2/2 (100%) of societies were advised to provide only urgent or emergent care and preserve resources for COVID-19 patients. One international society provided significant member resources including (1) COVID-19 recommendations for management of elective surgical procedures in aesthetic surgery, (2) COVID-19: service letter for patients, (3) General advice on personal protection equipment during the COVID-19 pandemic and (4) COVID-19 webinar series.

Discussion

This is the first study to evaluate the website information provided by national and international aesthetic surgery societies. The presence of COVID-19 information on national and international aesthetic surgery websites is scarce with two-thirds of sovereign nations not represented. There were limited links between national aesthetic surgery websites other than to conferences and courses. There were a few links from national aesthetic surgery websites to an international aesthetic surgery society (ISAPS). COVID-19 information was in general limited on national and international society websites, but there were exceptions. One international society, ISAPS, provided significant member and non-member resources including, COVID-19 recommendations for management of elective surgical procedures in aesthetic surgery, COVID-19: service letter for patients; general advice on personal protection equipment during the COVID-19 pandemic and a COVID-19 webinar series.

Although easy access to the Internet can provide much information for patients, the quality and accuracy of information are uncertain. Internet search engines are the most common means for finding medical information but are often not concerned with delivering correct material for patients [10]. National and/or international aesthetic society websites should provide high-quality and accurate information to both their members and patients. This study selected Google as the search engine for this study, as over 70% of web users worldwide use it as their primary search engine [10].

The Internet is a global system of interconnected computer networks. In contrast, the World Wide Web is a global collection of documents and other resources, linked by hyperlinks and URLs. National and international aesthetic societies must provide COVID-19 information via their websites to their member aesthetic surgeons. This World Wide Web is a global collection of documents and other resources; in the Internet era, aesthetic surgeons require reliable sources of online information [8, 11–13]. Enabling information technology platforms can optimize aesthetic surgery education and best standard of care [11–15]. Clinical practice guidelines can improve the quality of care and are helpful in summarizing evidence, standardizing management and guiding appropriate referrals [8, 11–15]. No national nor international aesthetic society website provided paediatric COVID-19 surgical guidelines for aesthetic surgeons.

National and international aesthetic surgery societies should develop the provider and practice COVID-19 guidance. These societies must determine the topics to be addressed based on questions that are received from its members and others, as well as input from their leadership and clinical experts outside aesthetic surgery. For each topic, national and international aesthetic surgery society staff must work with clinical experts to develop guidance in an iterative, collaborative fashion. This guidance refers to and highlights, where possible, evidence published in the peer-reviewed literature as well as guidance issued by local, national and international health authorities and professional organizations. Once draft guidance is developed for the topic, it must be reviewed by society leadership, who approve all statements regarding patient care. Approved guidance is then posted online. The guidance is updated as new information emerges and all content is reviewed periodically in its entirety by national and international aesthetic surgery society staff to ensure consistency with rapidly changing guidance from other organizations and government agencies. The date of the last review/update must be on the online page.

Particular national and international aesthetic surgery societies have social media accounts. Dual facets to aesthetic surgeons’ Internet use are information gathering and social networking. Social media groups provide social support and allow shared interaction. The interaction between national and international aesthetic surgery societies and aesthetic surgeons can be improved by the use of social media. It is important to acknowledge that confidentiality is an issue when discussing plastic in surgery in social media [9, 10].

This is the first study to evaluate the availability of information on the COVID-19 disease pandemic provided by national and international aesthetic surgery society websites. This information was in general limited on national and international society websites. There were exceptions.

There is minimal integration and standardization between websites and plastic surgical societies. In an increasingly technological health system, where the Internet and communication play a crucial role, it is essential that this deficiency be addressed. This highlights the opportunity for partnership between national and international plastic surgery societies to standardize the information and quality of care provided to aesthetic surgeons [8, 11–13]. A limitation of this study is that it could not evaluate whether direct information was provided by the national or international aesthetic society directly to their society members, e.g. by email or post.

This study suggests that improvement and increase in COVID-19 information provided by many national aesthetic surgery society websites may be improved by links to the ISAPS website and to other national aesthetic surgery society websites. National and international aesthetic surgery societies should provide their members with the most up-to-date, thorough and correct expert information to use in making decisions regarding the COVID-19 pandemic and care for aesthetic surgery patients [8, 13, 16]. National and international aesthetic surgery societies should not only explore a variety of opportunities of safe practice while following all the prescribed guidelines in current COVID-19 pandemic but more importantly endeavour to present a well-organized, constantly updated summary of COVID-19 management of aesthetic patients during the pandemic with emphasis on safe practice methods for patients and providers [17–19].

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights, or Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, informed consent is not required.