Update of Surgical Procedures During COVID -19

Volume 5 - Issue 3

Mohamed Mostafa Mossaad*

Received: July 01, 2020;   Published: July 15, 2020

DOI: 10.32474/RRHOAJ.2020.05.000215

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Abstract

There are presently increasing amounts of information concerning protecting the health care workers in the operating rooms. This article will bring the latest information, data, and recommendations for personnel in the operating room, as well as how to minimize risk of COVID infection. The present COVID-19 pandemic underlines the importance of a mindful utilization of financial and human resources. Preserving resources and manpower is paramount in healthcare. It is important to ensure the ability of surgeons and specialized professionals to function through the pandemic. A conscious effort should be made to minimize infection in this sector. A high mortality rate within this group would be detrimental. We aim to describe recommended clinical pathways for COVID-19-positive patients requiring acute non-deferrable surgical care. All hospitals should organize dedicated protocols and workforce training as part of the effort to face the current pandemic.

Background: Godwin J.et al. [1] have shown that the current COVID-19 pandemic, “when the destructive effects of natural or man-made forces to destroy the ability of a given area or community to meet the demand for health care” [1], During MCIs, preserving financial and human resources is crucial. A good preventive approach is mandatory in the phase of MCI response called mitigation. Wong J et al. [2] have reported in a review of operating room outbreak response in a large tertiary hospital in Singapore that in order to minimize resource exhaustion, the use of surgical appliances and staff must be well pondered and balanced [2]. Specialist, Surgeons and sub-specialized workers in general are the most valuable resource during MCI. Infection or death of subspecialized staff must be minimized to preserve the ability to face surgical emergencies and associated activities that will continue to occur or perhaps increase during MCI. When possible, all surgical procedures on all suspected COVID-19 patient should be postponed until confirmed infection clearance. Minimal staff should be involved when possible. If a large number of senior surgeons is exposed to infected patients, the possibility for them to become infected and require self-isolation is real and could potentially result in a dangerous shortage of senior expertise within surgical teams. Resource usage should be carefully considered when planning scheduled procedures, particularly with regard to materials, staff, devices, intensive care beds, blood components, etc. Caring for resource-intensive patients might be controversial during MCIs.
We aim to describe recommended clinical pathways for COVID-19-positive patients requiring acute non-deferrable surgical care. All suspected COVID-19-positive patients requiring surgical intervention must be treated as positive until proven otherwise in order to minimize infection spread. Clearly defined pathways must be available to healthcare professionals caring for these patients. Allocating dedicated senior staff to key management roles is crucial to minimize COVID-19 spread.
a) Use of Personal Protective Equipment (in the operating room, including appropriate donning/doffing of the PPE). b) Intubation Risks.
c) Specific Operative Risk Issues.
d) After Operation/Recovery (leaving the OR and the facility).
e) Going Home-What Should Be Done to Keep Your Family Safe.

Abbreviations: MCIs: Mass Casualty Events; PPE: Personal Protection Equipment; FFP: Filtering Face Piece; COA: COVID Operating Area; IRHW: Infectious-Risk Health Waste; HEPA: High-Efficiency Particulate Air; RSI: Rapid Sequence Intubation.

Abstract| Use of Personal Protective Equipment| Specific Operative Risk Issues| COVID 19 Operating Rooms| Operating Room Preparation| Personnel Dressing| Anesthesiologic Consideration| Intraoperative Regulations| PPE Undressing/Removal| Measures for PPE Removal| Sanitization and OR Preparations| Waste Disposal| Linen Management| Going Home-What Should Be Done to Keep Your Family Safe| Conclusion| References|