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COVID-19 后的骨科手术-大流行后恢复择期手术的蓝图。

Orthopaedic surgery after COVID-19 - A blueprint for resuming elective surgery after a pandemic.

机构信息

Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, S308433, Singapore.

出版信息

Int J Surg. 2020 Aug;80:162-167. doi: 10.1016/j.ijsu.2020.07.012. Epub 2020 Jul 15.

Abstract

BACKGROUND

The COVID-19 outbreak was fraught with danger and despair as many medically necessary surgeries were cancelled to preserve precious healthcare resources and mitigate disease transmission. As the rate of infection starts to slow, healthcare facilities and economies attempt to return to normalcy in a graduated manner and the massive pent-up demand for surgeries needs to eventually be addressed in a systematic and equitable manner.

MATERIALS AND METHODS

Guidelines from the Alliance of International Organizations of Orthopaedics and Traumatology, Orthopaedic Trauma Association, American College of Surgeons, American Society of Anaesthesiologists, Association of perioperative Registered Nurses, American Hospital Association, Centers for Medicare and Medicaid Services, World Health Organization and Centers for Disease Control and Prevention were evaluated and summarized into a working framework, relevant to orthopaedic surgeons.

RESULTS

The guiding principles for restarting elective surgeries in a safe and acceptable manner include up-to-date disease awareness, projection and judicious management of equipment and facilities, effective human resource management, a fair and transparent system to prioritize cases, optimization of peri-operative workflows and continuous data gathering and clinical governance.

CONCLUSION

The world was ill prepared for the initial COVID-19 outbreak. However, with effective forward planning, institutions can ramp-up elective surgical caseload in a safe and equitable manner.

摘要

背景

COVID-19 疫情爆发,大量医学上必需的手术被取消,以保护宝贵的医疗资源并减少疾病传播,这让许多人感到充满了危险和绝望。随着感染率开始放缓,医疗机构和经济开始逐步恢复正常,大量积压的手术需求需要以系统和公平的方式最终得到解决。

材料和方法

评估并总结了国际骨科和创伤组织联盟、骨科创伤协会、美国外科医师学会、美国麻醉师协会、围手术期注册护士协会、美国医院协会、医疗保险和医疗补助服务中心、世界卫生组织和疾病控制与预防中心的指南,形成了一个与骨科医生相关的工作框架。

结果

以安全和可接受的方式重启择期手术的指导原则包括最新的疾病认识、设备和设施的合理规划和管理、有效的人力资源管理、公平透明的病例优先级制度、优化围手术期工作流程以及持续的数据收集和临床治理。

结论

世界对最初的 COVID-19 疫情爆发毫无准备。然而,通过有效的前瞻性规划,医疗机构可以以安全和公平的方式逐步增加择期手术的工作量。

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