The Orthopaedic Trauma Service and COVID-19: Practice Considerations to Optimize Outcomes and Limit Exposure

Stinner, Daniel J.; Lebrun, Christopher; Hsu, Joseph R.; Jahangir, A. Alex; Mir, Hassan R.

doi:10.1097/bot.0000000000001782

Cited by 71 publications

(78 citation statements)

References 25 publications

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“…For those OPD cases which do not require an actual physical examination, telemedicine is a viable option in near future. Many of the guidelines have pointed to that [13,20]. What we can do is to first address all potential OPD patients through telemedicine and only those patients who indeed require a physical examination, to be called for actual physical OPD.…”

Section: Discussionmentioning

confidence: 99%

“…However, this cannot be done indefinitely. One of the practical things that has been implemented already in most of the hospitals in our country and around the globe is getting a COVID-19 RT-PCR done and only when the report comes negative, the patient to be taken for surgery [20]. The silver lining for our speciality is that most of the trauma patients having isolated injuries to the extremities can be managed conservatively till the report is negative.…”

Section: Discussionmentioning

confidence: 99%

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How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey

Keshav

Kumar

Sharma

et al. 2020

IJOO

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Backgroud Coronavirus Disease 2019 (COVID-19) has spread globally affecting all strata of people including the orthopaedic surgeons of India. We have witnessed a drastic fall in the number of patients. The aim of study was to assess the extent to which the Indian orthopaedic practice has been affected by the pandemic. Methods We conducted an online survey amongst currently practicing Indian orthopaedic surgeons. Those currently not in practice or under training or having left clinical practice before the onset of pandemic were excluded. A total of 533 orthopaedic surgeons took part in the study amongst which, complete responses were obtained from 407 individuals. Statistical analysis was done to see the association between demographic profile of study participants and various variables of orthopaedic practice. Results There was drastic fall in all the parameters of orthopaedic practice. Over half of the practicing surgeons witnessed fall in outpatients over 90%. Most had stopped elective surgeries (64%) and even emergency ones (21%) altogether. More than 50% of doctors had their earnings reduced by > 75%. We found a statistically highly significant association of reduction in earnings with the sector, type of setup and duration of practice. (p-value < 0.001). Conclusion This study suggests that orthopaedic surgeons across all sectors in different kinds of setups have been affected in their outpatient and operative numbers. With regards to earnings, those working in private and running their own (individual) hospitals & clinics have been most severely affected while those in government sector and medical colleges have been affected the least.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey

Keshav

Kumar

Sharma

et al. 2020

IJOO

View full text Add to dashboard Cite

show abstract

“…Coronavirus revolutionized the way we approach clinical cases, pre-operative surgery, and the surgery itself. We have to make our surgical decision not only on the basis of the traumatological evidence but also considering the safety measures to minimize the contagion risk [18].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team

Mauro

Rovere

Smimmo

et al. 2020

International Orthopaedics (SICOT)

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Background SARS-CoV-2 pandemic left a deep mark in the health systems around the globe, leading to an important change in the way we intend the access to the healthcare and its fruition. Hospitals faced something unexpected, and they underwent a deep change and so did orthopaedic activity. Materials and methods In "A. Gemelli" University hospital new protocols were adopted for the safe management of patients affected by SARS-CoV-2. Among these patients, six had to be treated also for orthopaedic problems. The management of these patients, from the admission in the Emergency Room (E.R). to the operating room (O.R.), followed the protocols we developed for the coronavirus crisis. Results Four among the six patients underwent surgical treatments. Two of them showed a change of their clinical status, due to a worsening of COVID-19 symptoms, so the surgical option was postponed. All of them were admitted to the Infectious Diseases Unit, rather than the Orthopaedic and Traumatology Unit, in order to provide the best measures to prevent the spread of the contagion and to ensure the best treatment for COVID-19. No O.R. staff was infected by SARS-CoV-2. Conclusions More studies are needed to provide a higher statistical significance to the safety measures taken in order to contrast the spread of SARS-CoV-2 in the Surgical Room. Orthopaedic surgeons are more exposed to the contagion due to the particular tools set they use. A more sensible and specific quick test for novel Coronavirus is particularly needed, due to the lack of sensitivity of the serological rapid test.

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“…Coronavirus revolutionized the way we approach clinical cases, pre-operative surgery and the surgery itself. We have to make our surgical decision not only on the basis of the traumatological evidence, but also considering the safety measures to minimize the contagion risk [18] Orthopedics and Traumatology is a surgical branch that, by de nition, has more risk factors for the contagion. Just consider the use of power tools, ultradrive and high-speed burr, determining an increased diffusion of blood in the surgical theatre [17,19].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Pandemic: management of patients affected by SARS-CoV-2 in Rome Covid Hospital 2 Trauma Center and safety of our surgical equipe 

Mauro

Smimmo

et al. 2020

Preprint

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Background. SARS-CoV-2 Pandemic left a deep mark in the Health Systems around the globe, leading to an important change in the way we intend the access to the healthcare and its fruition. Hospitals faced something unexpected and they underwent a deep change and so did the orthopedic activity.Materials and Methods. In “A. Gemelli” University hospital new protocols were adopted for the safe management of patients affected by SARS-CoV-2. Among these patients, six had to be treated also for orthopedic problems. The management of these patients, from the admission in the Emergency Room (E.R). to the operating room (O.R.), followed the protocols we predisposed for the Coronavirus crisis.Results. Four among the six patients underwent surgical treatments. Two of them showed a change of their clinical status, due to a worsening of the COVID-19 symptoms, so the surgical option was postponed. All of them were admitted to the Infectious Diseases Unit, rather than the Orthopedic and Traumatology Unit, in order to provide the best measures to prevent the spread of the contagion and to ensure the best treatment for the COVID-19. No O.R. staff was infected by SARS-CoV-2.Conclusions. More studies are needed to provide a higher statistical significance to the safety measures taken in order to contrast the spread of SARS-CoV-2 in the Surgical Room. Orthopedic surgeons are more exposed to the contagion due to the particular tools set they use. A more sensible and specific quick test for novel Coronavirus is particularly needed, due to the lack of sensibility of the serological rapid test.

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The Orthopaedic Trauma Service and COVID-19: Practice Considerations to Optimize Outcomes and Limit Exposure

Abstract: FIGURE 5. PPE worn in a COVID unknown patient consisting of a surgical hood in conjunction N95 respirator in addition to standard operating room PPE.

Cited by 71 publications

References 25 publications

How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey

How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey

COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team

COVID-19 Pandemic: management of patients affected by SARS-CoV-2 in Rome Covid Hospital 2 Trauma Center and safety of our surgical equipe

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The Orthopaedic Trauma Service and COVID-19: Practice Considerations to Optimize Outcomes and Limit Exposure

Abstract: FIGURE 5. PPE worn in a COVID unknown patient consisting of a surgical hood in conjunction N95 respirator in addition to standard operating room PPE.

Cited by 71 publications

References 25 publications

How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey

How Much has COVID-19 Pandemic Affected Indian Orthopaedic Practice? Results of an Online Survey

COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team

COVID-19 Pandemic:&nbsp;management of patients affected by SARS-CoV-2 in Rome Covid Hospital 2 Trauma Center and safety of our surgical equipe&nbsp;

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COVID-19 Pandemic: management of patients affected by SARS-CoV-2 in Rome Covid Hospital 2 Trauma Center and safety of our surgical equipe