Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

Gök, Ali Fuat Kaan; Eryılmaz, Mehmet; Özmen, Mehmet Mahir; Ali̇moğlu, Orhan; Ertekın, Cemalettın; Kurtoğlu, Mehmet

doi:10.14744/tjtes.2020.79954

Cited by 44 publications

(48 citation statements)

References 38 publications

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“…[5,6] To maintain the sustainability of the healthcare system, the protection of health-care providers should be the top priority, and hospitals should reorganize themselves, provide decent protective equipment to all staff and use the workforce effectively. [7] In our hospital, where we conducted this study, which is a pandemic hospital, after the computerized tomography of the patients were taken, all emergency operations, including appendectomy, continued taking into consideration the safety of the personnel with the personal protective equipment in the operating rooms where the negatives were operated if COVID-Negative was operated, and in the operating rooms where COVID-Positive or suspect positive patients were operated. After the operation, isolation was tried to be divided by dividing the clinics where the patients will be followed, and this strategy can be developed if the physical conditions allow.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis Of The Management Of Acute Appendicitis Between The Normal Period And COVID-19 Pandemic

Meriç

Aktokmakyan

Tokoçin

et al. 2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency. There is no adequate information to evaluate the effects of the COVID-19 pandemic on acute appendicitis and its surgical management. The present comparative study reports successful appendectomy and infection control in patients with appendicitis during the COVID-19 pandemic and last year covering the same period. METHODS: This retrospective observational study was conducted in acute appendicitis-treated patients from 13.03.19 to 13.05.19 and from 13.03.20 to 13.05.20, respectively. RESULTS: This study included 150 patients (110 patients in 2019; 40 patients in 2020 (during COVID-19 pandemic)). The patients were named as Group A (Normal period) and Group B (Pandemic period), respectively. The groups were comparable as there was no significant difference between the mean age, mean BMI, and mean length of stay. There is a significant difference between the comorbidities of Group A and Group B (p=0.033). There was no significant difference between the laboratory and radiological findings of Group A and Group B. There was a significant difference between the perforation number of Group A and Group B (p=0.029). There was no significant difference between the needs of ICU and conversion from laparoscopic to conventional appendectomy of Group A and Group B. CONCLUSION: The findings obtained in this study suggest that late admission to the hospital caused complicated cases and made acute appendicitis management more difficult during the pandemic period, which was already a troubling period. During the COVID-19 pandemic, the principles applied to emergency surgery for infected patients should be applied to both suspected and confirmed cases.

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis Of The Management Of Acute Appendicitis Between The Normal Period And COVID-19 Pandemic

Meriç

Aktokmakyan

Tokoçin

et al. 2020

Ulus Travma Acil Cerrahi Derg

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“…The operating rooms (ORs) were divided as COVID operating room where only COVID positive surgeries were done. COVID suspect operating room was all hyperacute cases were done, which had no time to wait for the results Rt-PCR and non-COVID operating room where Rt-PCR negative cases were done [ 3 ].…”

Section: Aimmentioning

confidence: 99%

Experience of a surgeon at the emergency department during COVID-19 pandemic

Mehanathan¹,

Edwards²,

Athisayamani³

et al. 2020

Annals of Medicine and Surgery

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Introduction The COVID pandemic, which started on 11th March as per the World Health Organization, has resulted in a drastic change in health care delivery, including emergency services. Most health workers have deviated towards COVID care delivery; only a few were available for non-COVID conditions. All elective and non-essential services were postponed resulting in the increased burden of the emergency department. The emergency department had to provide essential emergency care with available staff without exposing them to the virus. Triaging of the patients was modified according to the needs. Methods The statistics of the emergency department of this period (April and May 2020) are compared with the same period of previous years (2018–2019) with the number of patients, indications, and complications. The methods of triaging and preparation were discussed. Discussion The number of patients admitted to the emergency department (ED) was low during the COVID pandemic. Nevertheless, they got admitted with complications due to delay in accessing the health care facility. Patients with diabetic foot ulcers were also presenting late, leading to an increased number of the forefoot and below knee amputations. In trauma, the emergency department has maintained the same death rate as previous years by giving great care. The indications for tracheostomy were worrisome because it would have been prevented if the patients presented early. Pediatric patients were also presented late, resulting in increased mortality. Some cancer patients also presented with a complication in the emergency department because of the postponement of elective surgeries. Conclusion There is a delay in accessing the health care delivery for non-COVID conditions resulting in more amputations of limbs and resections of the bowel. So the type of care in the emergency department was changed due to atypical presentation and complicated cases. It is necessary to ensure the provision of high quality health care delivery to non-COVID patients also.

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“…In the preoperative period, it is seen that Turkish surgeons evaluate their patient in terms of COVID-19 either with symptomatic evaluation, thorax imaging or a PCR test. We think that symptomatic evaluation should be done to all patients, and all emergency cases should be treated as a positive case, and in elective cancer cases, thorax tomography, which is already part of metastase screening, should be evaluated (7). In non-urgent suspected patients, PCR testing may be required before surgery.…”

Section: Discussionmentioning

confidence: 99%

The attitude of Turkish general surgeons during the COVID-19 pandemic: results of “general surgery COVID-19 pandemic attitude survey”

Çolakoğlu¹,

Özgün²,

Pişkin³

et al. 2020

Turk J Surg

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Objective: The whole world is dealing with the COVID-19 pandemic, and healthcare professionals are the most affected group. The aim of this study was to evaluate the knowledge of general surgeons about COVID-19 and understand the attitude and current situation of our colleagues. Material and Methods: This descriptive study comprised general surgeons working in different parts of Turkey. A survey with 23 questions was prepared to determine the demographic characteristics of the participants, workplace characteristics, change in daily work practices and their attitudes in the pandemic process. Results: A total of 332 forms were evaluated. Survey results show that the majority of surgeons have changed their daily surgical practices. Many surgeons take part in the treatment of COVID-19. While most benign cases are delayed, the managemet of malignant cases differs. There are also differences in the evaluation of patients preoperatively and the type of operation. Personal protective measures are followed. While the rate of infected surgeons is low, the majority of surgeons have concerns about infection. Conclusion: Turkish surgeons have managed to get a quick reaction from the start of the pandemic. However, there are still differences in preoperative patient evaluation and operation selection and precautions during the operation. Surgeons also should be informed about the management of malignant patients.

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Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

Cited by 44 publications

References 38 publications

Comparative Analysis Of The Management Of Acute Appendicitis Between The Normal Period And COVID-19 Pandemic

Comparative Analysis Of The Management Of Acute Appendicitis Between The Normal Period And COVID-19 Pandemic

Experience of a surgeon at the emergency department during COVID-19 pandemic

The attitude of Turkish general surgeons during the COVID-19 pandemic: results of “general surgery COVID-19 pandemic attitude survey”

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