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Fecal contamination and increased blood loss during colectomy should raise suspicion for potential postoperative anastomotic leakage.

Obesity and smoking are modifiable risk factors for SSIs after VIHR, whereas a low serum albumin level is a modifiable risk factor for prolonged LOS. Addressing factors preoperatively might improve patient outcome, and reduce health care expenditures associated with VIHR. In addition, if feasible, the laparoscopic approach should be strongly considered.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has led to widespread postponement and cancelation of elective surgeries in the United States. We designed and administered a global survey to examine the impact of COVID-19 on vascular surgeons. We describe the impact of the pandemic on the practices of Vascular Surgeons in the United States. Methods The Pandemic Practice, Anxiety, Coping, and Support Survey for Vascular Surgeons is an anonymous cross-sectional survey sponsored by the Society for Vascular Surgery Wellness Task Force disseminated April 14-24, 2020. This analysis focuses on pattern changes in vascular surgery practices in the United States including the inpatient setting, ambulatory, and vascular laboratory setting. Specific questions regarding occupational exposure to COVID-19, adequacy of personal protective equipment (PPE), elective surgical practice, changes in call schedule, and redeployment to non-vascular surgery duties were also included in the survey. Regional variation was assessed. The survey data were collected using REDCap and analyzed using descriptive statistics. Results A total of 535 vascular surgeons responded to the survey from 45 states. Most of the respondents were male (73.1%), White (70.7%), practiced in urban settings (81.7%), and in teaching hospitals (66.8%). Almost half were in hospitals with greater than 400 beds (46.4%). There was no regional variation in the presence of pre-operative COVID-19 testing, COVID-19 OR protocols, adherence to national surgical standards, and the presence of PPE. The overwhelming majority of respondents (91.7%) noted elective surgery cancellation, with the Northeast and Southeast regions having the most case cancellations 94.2% and 95.8% respectively %). The Northeast region reported the highest percentage of operations/procedures on patients with COVID-19, which was either identified at the time of the surgery or later in the hospital course (82.7%). Ambulatory visits were performed via telehealth (81.3%), with 71.1% having restricted hours. Over half of OBLs were closed, although there was regional variation with over 80% in the Midwest being closed. Cases performed in OBLs focused on critical limb ischemia (42.9%) and dialysis access maintenance (39.9%). Call schedules modifications were common, although the number of call days remained the same (45.8%). Conclusions Vascular surgeons in the United States report substantial impact on their practices during the COVID-19 pandemic, and regional variations are demonstrated - particularly in OBL utilization, ICU bed availability, and COVID-19 exposure at work.