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COVID-19 疫情期间意大利某大骨科转诊中心骨科手术组织和规划策略:帕多瓦大学骨科的经验。

COVID-19 strategy in organizing and planning orthopedic surgery in a major orthopedic referral center in an area of Italy severely affected by the pandemic: experience of the Department of Orthopedics, University of Padova.

机构信息

Department of Orthopedics and Orthopedic Oncology, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.

出版信息

J Orthop Surg Res. 2020 Jul 23;15(1):279. doi: 10.1186/s13018-020-01740-4.

DOI:10.1186/s13018-020-01740-4
PMID:32703305
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7376824/
Abstract

BACKGROUND

According to the required reorganization of all hospital activities, the recent COVID-19 pandemic had dramatic consequences on the orthopedic world. We think that informing the orthopedic community about the strategy that we adopted both in our hospital and in our Department of Orthopedics could be useful, particularly for those who are facing the pandemic later than Italy.

METHODS

Changes were done in our hospital by medical direction to reallocate resources to COVID-19 patients. In the Orthopedic Department, a decrease in the number of beds and surgical activity was stabilized. Since March 13, it has been avoided to perform elective surgery, and since March 16, non-urgent outpatient consultations were abolished. This activity reduction was associated with careful evaluation of staff and patients: extensive periodical swab testing of all healthcare staff and swab testing of all surgical patients were applied.

RESULTS

These restrictions determined an overall reduction of all our surgical activities of 30% compared to 2019. We also had a reduction in outpatient clinic activities and admissions to the orthopedic emergency unit. Extensive swab testing has proven successful: of more than 160 people tested in our building, only three COVID-19 positives were found, and of over more than 200 surgical procedures, only two positive patients were found.

CONCLUSIONS

Extensive swab test of all people (even if asymptomatic) and proactive tracing and quarantining of potential COVID-19 positive patients may diminish the virus spread.

摘要

背景

根据对所有医院活动的必要重组,最近的 COVID-19 大流行对骨科界产生了巨大影响。我们认为,向骨科界通报我们在医院和骨科部门所采用的策略可能会有所帮助,尤其是对于那些比意大利更晚面临大流行的人。

方法

通过医疗方向的改变,我们在医院重新分配资源以应对 COVID-19 患者。在骨科,减少了床位和手术活动。自 3 月 13 日以来,已避免进行择期手术,自 3 月 16 日以来,取消了非紧急门诊咨询。这种活动减少与对员工和患者的仔细评估有关:对所有医护人员进行广泛的定期拭子检测,并对所有手术患者进行拭子检测。

结果

这些限制使我们的所有手术活动总体减少了 30%,与 2019 年相比。我们还减少了门诊诊所活动和骨科急诊病房的收治。广泛的拭子检测已被证明是成功的:在我们的建筑中测试了超过 160 人,仅发现了 3 例 COVID-19 阳性病例,超过 200 例手术中,仅发现了 2 例阳性患者。

结论

对所有人员(即使无症状)进行广泛的拭子检测,并主动追踪和隔离潜在的 COVID-19 阳性患者,可能会减少病毒传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/6dd1f53a93ba/13018_2020_1740_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/16b891b6274d/13018_2020_1740_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/b66e003e19cc/13018_2020_1740_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/6dd1f53a93ba/13018_2020_1740_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/16b891b6274d/13018_2020_1740_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/26cde7ce787f/13018_2020_1740_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/ebd29049ea78/13018_2020_1740_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/b66e003e19cc/13018_2020_1740_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/433b/7379760/6dd1f53a93ba/13018_2020_1740_Fig5_HTML.jpg

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