Surgical and operating room procedures during the COVID-19 pandemic (multiple reviews)
What is this? The COVID-19 pandemic is affecting the provision of surgery for patients and several rapid systematic reviews have been done. More details of these, including citations and links to their full text are available further down this summary.
What was found: Based on the available evidence at the time of these reviews, recommendations for practices relevant to surgery include the use of pre-operative planning, negative pressure ventilation in operating theatres, limited personnel, single-use equipment, designated donning and doffing areas, dedicated COVID-19 theatres and teams and COVID-free facilities, using regional anaesthesia to minimise duration of surgery, limiting the use of electro-cauterization within procedures, limiting the use of endoscopic procedures to emergencies and selected suspected or confirmed cancer patients and telemedicine for postoperative follow-up.
Based on the available evidence at the time of these reviews, recommendations for staff include use of appropriate personal protective equipment, training, screening, showers following procedures and the provision of psychological support for healthcare workers.
Based on the available evidence at the time of these reviews, recommendations for patients include screening, self-isolation before elective admission and the use of surgical masks during admission.
What are the reviews:
Citation: De Simone B, Chouillard E, Di Saverio S, et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. The Annals of The Royal College of Surgeons of England. 2020 May;102(5):323-32.
In this rapid review, the authors searched for articles on COVID-19 and surgery in an emergency setting. They restricted their searches to articles published in English between 15 December 2019 and 30 March 2020. They included 12 articles.
Citation: Hojaij FC, Chinelatto LA, Boog GH, Kasmirski JA, Lopes JV, Sacramento FM. Surgical Practice in the Current COVID-19 Pandemic: A Rapid Systematic Review. Clinics. 2020;75:e1923.
In this rapid review, the authors searched for research or recommendations regarding surgery dynamics, screening of patients and elective procedures during the COVID-19 pandemic. They did not restrict their search by date, type or language of publication and completed the search on 4 April 2020. They included 21 research articles, 5 opinion articles, 4 editorials and 9 other articles.
Citation: Spolverato G, Capelli G, Restivo A, et al. The management of surgical patients during the COVID-19 pandemic. Surgery. 2020;168(1):4-10.
In this rapid review, the authors searched for research or opinion papers on the epidemiology and diagnosis of COVID-19, the management of cancer and surgical patients, and the safety of healthcare workers during the pandemic. They did not restrict by type or language of publication and searched for articles published between January 1998 and 2 April 2020. They included 28 retrospective studies.
Citation: Pavan N, Crestani A, Abrate A, et al. Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era. European Urology Focus. 2020 Jun; 6(5):1058-69.
In this rapid review, the authors searched for clinical and pre-clinical studies evaluating the risk of viral transmission to healthcare workers from any surgical treatment of patients with a viral disease, or studies evaluating the presence of virus remnants in surgical smoke. They did not restrict their search by language of publication and completed the search on 2 April 2020. They included 14 clinical studies, 8 pre-clinical studies and 2 papers reporting both clinical and pre-clinical study data.
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