Important Guidelines for Surgery in COVID-19 Pandemic; A Review Study

Document Type : Review Article

Authors

1 Instructor, Department of Operating Room, Community Health Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

2 Assistant Professor, Community Oriented Nursing and Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

3 Instructor, Department of Adult and Elderly Nursing, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran

4 Instructor, Department of Operating Room, Islamic Azad University, Aligudarz Branch, Aligudarz, Iran

5 Department of Emergency Medical Services, Isfahan University of Medical Sciences, Isfahan, Iran

6 Instructor, Department of Operating Room, Community-Oriented Nursing Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: In the case of COVID-19 pandemic and the risks of transmitting the disease to other people in the hospital environment, and the need to performing some surgeries, implementing preventive measures in operating rooms should be seriously considered. The aim of this study was to investigate the important surgical instructions during COVID-19 pandemic.Methods: This was a systematic review study in which data were collected by searching PubMed, Scopus, and Scientific Information Database (SID) databases and Google Scholar search engine with the keywords Corona, COVID 19, operating room, and surgery. Inclusion criteria of articles included published in 2020 and 2021, original articles, English language, and having the keywords in the title or abstract. By applying inclusion and exclusion criteria, out of 100 articles and selected sites, 54 articles were selected, and after the second review by another researcher, 29 articles completely related to the subject were reviewed and analyzed.Findings: Some of the most important points during the COVID-19 pandemic in the operating room space is to reduce the number of elective surgeries, correct use of personal protective equipment by the surgical team in the operating room, use of a small port to prevent gas leakage and low insufflation pressure in laparoscopic surgery, use of disposable moisturizing filter in the operating room environment for better ventilation, use of disposable airway and video laryngoscope by anesthesiologist, and increasing the frequency of ventilation more than 25 times per hour between surgeries.Conclusion: It is necessary to install provided instructions in the operating room, and the operating room supervisors have close monitor over its proper implementation.

Keywords

References

  1. World Health Organization. Laboratory testing of human suspected cases of novel coronavirus (nCoV) infection: Interim guidance, 10 January 2020. WHO/2019-nCoV/laboratory/2020.1. Geneva, Switzerland: WHO; 2020.
  2. Coccolini F, Perrone G, Chiarugi M, Di Marzo F, Ansaloni L, Scandroglio I, et al. Surgery in COVID-19 patients: operational directives. World J Emerg Surg 2020; 15(1): 25.
  3. Mascha EJ, Schober P, Schefold JC, Stueber F, Luedi MM. Staffing with disease-based epidemiologic indices may reduce shortage of intensive care unit staff during the COVID-19 Pandemic. Anesth Analg 2020; 131(1): 24-30.
  4. Raghavan D, Tan AR, Story ES, Burgess EF, Musselwhite L, Kim ES, et al. Management changes for patients with endocrine-related cancers in the COVID-19 pandemic. Endocr Relat Cancer 2020; 27(9): R357-R374.
  5. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13): 1239-42.
  6. Peloso A, Moeckli B, Oldani G, Triponez F, Toso C. Response of a European surgical department to the COVID-19 crisis. Swiss Med Wkly 2020; 150: w20241.
  7. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
  8. Sud A, Jones ME, Broggio J, Loveday C, Torr B, Garrett A, et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol 2020; 31(8): 1065-74.
  9. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061-9.
  10. Diaz A, Sarac BA, Schoenbrunner AR, Janis JE, Pawlik TM. Elective surgery in the time of COVID-19. Am J Surg 2020; 219(6): 900-2.
  11. Ficarra V, Novara G, Abrate A, Bartoletti R, Crestani A, De NC, et al. Urology practice during the COVID-19 pandemic. Minerva Urol Nefrol 2020; 72(3): 369-75.
  12. American College of Surgeons. COVID-19 Guidelines for Triage of Cancer Surgery Patients [Onlline]. [cited 2020 Mar] Available from: URL: https://www.facs.org/covid-19/clinicalguidance/elective-case/cancer-surgery
  13. Deo SVS, Kumar S, Kumar N, Saikia J, Bhoriwal S, Bhatnagar S, et al. Guiding Principles for Cancer Surgery during the COVID-19 Pandemic. Indian J Surg Oncol 2020; 1-8. [Epub ahead of print].
  14. Gao Y, Xi H, Chen L. Emergency surgery in suspected COVID-19 patients with acute abdomen: Case series and perspectives. Ann Surg 2020; 272(1): e38-e39.
  15. Carron JD, Buck LS, Harbarger CF, Eby TL. A simple technique for droplet control during mastoid surgery. JAMA Otolaryngol Head Neck Surg 2020; 146(7): 671-2.
  16. Somashekhar SP, Acharya R, Manjiri S, Talwar S, Ashwin KR, Rohit KC. Adaptations and safety modifications to perform safe minimal access surgery (minimally invasive surgery: Laparoscopy and robotic) during the COVID-19 Pandemic. Surg Innov 2021; 28(1): 123-33.
  17. Miller L, Lukovic E, Wagener G. Guiding airway management and personal protective equipment for COVID-19 intubation teams. Br J Anaesth 2020; 125(3): e288-e290.
  18. Brucher BL, Nigri G, Tinelli A, Lapena JF, Espin-Basany E, Macri P, et al. 2020. COVID-19: Pandemic surgery guidance. 4open 2020; 3(1): 1-19.
  19. Srivastava A, Nasta AM, Pathania BS, Sundaram E, Jani KV, Manickavasagam K, et al. Surgical practice recommendations for minimal access surgeons during COVID 19 pandemic - Indian inter-society directives. J Minim Access Surg 2020; 16(3): 195-200.
  20. Francis N, Dort J, Cho E, Feldman L, Keller D, Lim R, et al. SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic. Surg Endosc 2020; 34(6): 2327-31.
  21. Schwarz L, Tuech JJ. Is the use of laparoscopy in a COVID-19 epidemic free of risk? Br J Surg 2020; 107(7): e188.
  22. Ti LK, Ang LS, Foong TW, Ng BSW. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anaesth 2020; 67(6): 756-8.
  23. Rodrigues-Pinto R, Sousa R, Oliveira A. Preparing to perform trauma and orthopaedic surgery on patients with COVID-19. J Bone Joint Surg Am 2020; 102(11): 946-50.
  24. Sawhney C, Singh Y, Jain K, Sawhney R, Trikha A. Trauma care and COVID-19 pandemic. J Anaesthesiol Clin Pharmacol 2020; 36(Suppl 1): S115-S120.
  25. Firstenberg MS, Libby M, Ochs M, Hanna J, Mangino JE, Forrester J. Isolation protocol for a COVID-2019 patient requiring emergent surgical intervention: Case presentation. Patient Saf Surg 2020; 14: 15.
  26. American College of Surgeons. COVID-19: Considerations for Optimum Surgeon Protection Before, During, and After Operation [Online]. [cited 2020 Apr 1]; Available from: URL: https://www.facs.org/covid-19/clinical-guidance/surgeon-protection
  27. Chetan MR, Tsakok MT, Shaw R, Xie C, Watson RA, Wing L, et al. Chest CT screening for COVID-19 in elective and emergency surgical patients: experience from a UK tertiary centre. Clin Radiol 2020; 75(8): 599-605.
  28. Beamish AJ, Brown C, Abdelrahman T, Ryan Harper E, Harries Rl, Egan RJ, et al. International surgical guidance for COVID-19: Validation using an international Delphi process - Cross-sectional study. Int J Surg 2020; 79: 309-16.
  29. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet 2020; 395(10231): 1225-8.

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History

  • Receive Date: 13 February 2021
  • Revise Date: 02 May 2024
  • Accept Date: 06 April 2022

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