General Surgery Department and Simulation Center, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy.
Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy.
Surg Today. 2020 Oct;50(10):1159-1167. doi: 10.1007/s00595-020-02086-4. Epub 2020 Jul 27.
In March, 2020, the World Health Organization declared COVID-19 a pandemic. The absence of previous knowledge of COVID-19 has made decision-making difficult for all in health care, including surgical departments. We reviewed the management recommendations for surgical activity and changes to surgical practice, identifying concordances and discrepancies, based on the literature published in the early phase of the pandemic.
We searched the electronic datasets, PubMed Database, Google, and Google Scholar, using the keywords "SARS-CoV-2", "COVID-19", "surgery", "recommendations", "guideline", and "triage". The search was limited to the first 2 months after the pandemic began and was closed on May 6, 2020.
Twenty papers were included in the analysis and their recommendations are divided into the following categories: 1. general aspects, such as maintaining the safety of health personnel and indications for surgery. 2. The preoperative phase, with recommendations about activating different care pathways for COVID-19 positive patients. 3. The operative phase, with recommendations about activating safety measures for aerosol-generating procedures. 4. The postoperative phase, with recommendations for managing operating theatres and patient transfers.
The recommendations proposed in the revised documents are considered good practices aimed at keeping patients and healthcare professionals safe. However, these recommendations must be contextualized in each individual hospital.
2020 年 3 月，世界卫生组织宣布 COVID-19 大流行。由于对 COVID-19 缺乏以往的了解，这使得医疗保健部门（包括外科部门）的所有人员在决策时都面临困难。我们根据大流行早期发表的文献，审查了外科活动管理建议和外科实践的改变，确定了一致和不一致之处。
我们使用“SARS-CoV-2”“COVID-19”“surgery”“recommendations”“guideline”和“triage”等关键词在电子数据库、PubMed 数据库、Google 和 Google Scholar 中进行了检索。搜索范围限于大流行开始后的头 2 个月，并于 2020 年 5 月 6 日关闭。
共有 20 篇论文被纳入分析，其建议分为以下几类：1. 一般方面，如保持卫生人员的安全和手术指征。2. 术前阶段，对 COVID-19 阳性患者的不同护理路径的激活建议。3. 手术阶段，对气溶胶生成程序的安全措施的激活建议。4. 术后阶段，对手术室和患者转移的管理建议。
修订文件中提出的建议被认为是保护患者和医护人员安全的良好做法。然而，这些建议必须在每个医院的具体情况下进行调整。
