Perspectives on Surgery in the Time of COVID-19: Safety First

Cohen, Sarah L.; Liu, Graace; Abrão, Maurício Simões; Smart, Neil; Heniford, Todd B.

doi:10.1016/j.jmig.2020.04.003

Cited by 73 publications

(80 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A growing number of articles are published at this moment covering all aspects of contamination prevention, elevated surgical risk and clinical management of COVID-19-positive patients. The question remains if elective surgery is still advisable on infected patients at all or should be generally postponed [18,19].…”

Section: Introductionmentioning

confidence: 99%

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Kaye¹,

Paprottka²,

Escudero³

et al. 2020

Aesth Plast Surg

101

145

View full text Add to dashboard Cite

Background The worldwide spread of a novel coronavirus disease has led to a near total stop of nonurgent, elective surgeries across all specialties in most affected countries. In the field of aesthetic surgery, the selfimposed moratorium for all aesthetic surgery procedures recommended by most international scientific societies has been adopted by many surgeons worldwide and resulted in a huge socioeconomic impact for most private practices and clinics. An important question still unanswered in most countries is when and how should elective/aesthetic procedures be scheduled again and what kind of organizational changes are necessary to protect patients and healthcare workers when clinics and practices reopen. Defining manageable, evidence-based protocols for testing, surgical/ procedural risk mitigation and clinical flow management/contamination management will be paramount for the safety of non-urgent surgical procedures. Methods We conducted a MEDLINE/PubMed research for all available publications on COVID-19 and surgery and COVID-19 and anesthesia. Articles and referenced literature describing possible procedural impact factors leading to exacerbation of the clinical evolution of COVID-19positive patients were identified to perform risk stratification for elective surgery. Based on these impact factors, considerations for patient selection, choice of procedural complexity, duration of procedure, type of anesthesia, etc., are discussed in this article and translated into algorithms for surgical/anesthesia risk management and clinical management. Current recommendations and published protocols on contamination control, avoidance of crosscontamination and procedural patient flow are reviewed. A COVID-19 testing guideline protocol for patients planning to undergo elective aesthetic surgery is presented and recommendations are made regarding adaptation of current patient information/informed consent forms and patient health questionnaires. Conclusion The COVID-19 crisis has led to unprecedented challenges in the acute management of the crisis, and the wave only recently seems to flatten out in some countries. The adaptation of surgical and procedural steps for a riskminimizing management of potential COVID-19-positive patients seeking to undergo elective aesthetic procedures in the wake of that wave will present the next big challenge for the aesthetic surgery community. We propose a clinical algorithm to enhance patient safety in elective surgery in the context of COVID-19 and to minimize cross-contamination between healthcare workers and patients. New evidence-based guidelines regarding surgical risk stratification, testing, and clinical flow management/contamination management are proposed. We believe that only the continuous development and broad implementation of guidelines like the ones proposed in this paper will allow an early reintegration of all aesthetic procedures into the scope of surgical care currently performed and to prepare

show abstract

Section: Introductionmentioning

confidence: 99%

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Kaye¹,

Paprottka²,

Escudero³

et al. 2020

Aesth Plast Surg

101

145

View full text Add to dashboard Cite

show abstract

“…Currently, multiple guidelines, reviews and directives are being published to improve the quality of care during the pandemic [16][17][18][19][20]. Cohen et al propose, that among COVID-19 positive patients we should postpone elective surgery until the patient has recovered [21]. Unfortunately, not every kind of procedure can be postponed inde nitely.…”

Section: Discussionmentioning

confidence: 99%

Surgical Care in Poland after COVID19 Outbreak: A National Survey.

Stefura

Rymarowicz

Wysocki

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: During COVID-19 pandemic, it is necessary to collect and analyze data concerning management of hospitals and wards to work out solutions for potential future crisis. The objective of the study was to investigate how surgical wards in Poland are managing during rapid development of the COVID-19 pandemicMethods: An anonymous, online survey was designed and distributed to surgeons and surgery residents working in surgical departments during pandemic. Responders were divided into two groups: Group 1 (responders working in a “COVID-19-dedicated” hospital) and Group 2 (responders working in other hospitals). Results: Overall, 323 responders were included in the study group, 30.03% of which were female. Medical staff deficits were reported by 21.15% responders from Group 1 and 29.52% responders from Group 2 (p=0.003). The mean number of elective surgeries performed weekly prior to the pandemic in Group 1 was 40.37±46.31 and during the pandemic was 13.98±37.49 (p<0.001). In Group 2, the mean number of elective surgeries performed weekly before the start of the pandemic was 26.85±23.52 and after the start of the pandemic, it was 7.65±13.49 (p<0.001). There were significantly higher reported levels of preparedness in Group 1 in terms of: theoretical training of the staff, equipping the staff and adapting the operating theater to safely perform procedures on patients with COVID-19. Overall, 62.23% of responders presume being infected with SARS-CoV-2.Conclusions: SARS-CoV-2 pandemic had a significantly negative impact on surgical wards. Despite the preparations, the number of responders who presume being infected with SARS-CoV-2 during present crisis is high.Trial registration: The study was registered in https://www.clinicaltrials.gov/ registry (NCT04368026).

show abstract

“…If there is no life-threatening condition in the COVID-19 (+) patient requiring surgery, the surgical treatment should be postponed until full recovery, nonoperative treatment modalities may be implemented when possible [11]. Although different attitudes between laparoscopy and laparotomy are being discussed in COVID-19 (+) patients [7,8], we recommend laparotomy at our institution if surgery cannot be postponed. If the decision is in the direction of laparotomy, minilaparotomy should be performed if possible (Figure 1).…”

Section: General Commentsmentioning

confidence: 99%

“…In light of all limited data, it may be hard to find the right way to act. At the same time, some scientists advocate the superiority and the high preferability of minimally invasive surgery in all patients [7], some scientists defend the triage, testing and protection, and minimize and delay the surgical decision on COVID-19 (+) patients [8]. The same authors argue that if the patient needs urgent surgery, and not have enough time to test the patient, laparotomy should be performed to minimize the risks.…”

Section: Introductionmentioning

confidence: 99%

Gynecological laparoscopic surgery in the shade of COVID-19 pandemic

Altınbaş¹,

Tapisiz²,

Üstün³

2020

Turk J Med Sci

View full text Add to dashboard Cite

Surgical safety and advantages of laparoscopy during the COVID-19 pandemicSince January, in the three months, changing in the actual policies and getting out of the routine, the decision of the route of surgery either by traditional open surgery or laparoscopic surgery is being discussed and stated regarding surgical safety concerns [2]. The first decision arises from the thought if the patient's situation needs an urgent intervention or not. The second is that if the patient needs urgent surgery, what will be the route, laparoscopy or laparotomy?According to our traditional knowledge, the use of laparoscopy offers many benefits to patients such as shorter recovery time and hospital stay, lower risk of post-surgical complications, reduced risk of pain and pain medication, less bleeding and risk of haemorrhage during the operation [3]. If looked at the point of the surgeon and surgical staff, Abstract: A global public health problem with a high rate spread and transmission, Coronavirus outbreak has become the most talkedabout matter throughout the world. We are severely affected by the nations with vast numbers of deaths; it was hard to predict such a colossal pandemic with terrifying consequences. Elective surgeries are limited, but situations requiring an urgent gynaecological or obstetric surgical approach must still be performed during the COVID-19 pandemic. Concerns regarding surgical safety and the risk of viral transmission during surgery are of great importance. In this review, we aimed to summarize the concepts related to laparoscopic gynecological surgery during COVID-19 pandemic in the light of current literature.

show abstract

Perspectives on Surgery in the Time of COVID-19: Safety First

Cited by 73 publications

References 5 publications

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Elective, Non-urgent Procedures and Aesthetic Surgery in the Wake of SARS–COVID-19: Considerations Regarding Safety, Feasibility and Impact on Clinical Management

Surgical Care in Poland after COVID19 Outbreak: A National Survey.

Gynecological laparoscopic surgery in the shade of COVID-19 pandemic

Contact Info

Product

Resources

About