Surgery Scheduling in a Crisis

The clinical consequences of the COVID‐19 lockdown: A report from an Italian referral ENT department

“…All surgical procedures were reclassified according to the possibility of delaying them without provoking harm to the patient: for less than 24 hours (emergency, for example, severe bleeding), for less than 48 hours (urgency, e.g., orbital complications from sinusitis with no improvement after medical management), for less than 7 days (semiurgency, e.g., histology-proven malignancy deemed to be suitable for a primary surgical treatment by our multidisciplinary cancer team, laryngeal lesions suspected to be malignant, pituitary tumors with initial visual impairment, etc.). 18 For the case series, the following selection criteria were applied to extract the patients: (Table 1) while 9 patients were treated as emergency or urgency ( Table 2). The volume of elective procedures decreased by 78% while, the number of emergency/urgency procedures increased by 128% in the weeks 11 to 18 compared to the prelockdown period.…”

Roadmap for Restarting Elective Surgery During/After COVID-19 Pandemic

“…Such decisions, depending upon availability of resources (personnel: surgeons/anesthesiologists/nurses, technology: ventilators, supplies: PPE/blood products, and postoperative resources: ICU beds), are easy to make with logic and sound surgical judgment ( Fig. 1) [30][31][32]. In case of any doubt, help can be sought from a specially created in-hospital surgical review committee and/or objective guidelines/algorithms published by several apex academic organizations [30,31].…”

Backlog to Surgery due to COVID-19 and Considerations to Address to Catch-up Safely

“…34 A recent publication has developed a decision tree algorithm for PPE use in order to protect operating-team staff whilst conserving PPE supplies, with the authors stating that "crisis-era resource consciousness should become part of surgery's new normal." 35 The availability of resources in general, such as surgical instruments, anaesthesia supplies, ICU capacity and other surgical theatre equipment, will also be a limiting factor to the full recovery, due to the interruptions in manufacturing and/or transport processes during the pandemic. 6 It is expected that once operations resume, there will be great competition for hospital supplies, human resources and operating rooms between the different surgical and medical (sub)specialties.…”