Surgical Considerations in Patients with COVID-19

Liang, Zhen; Chong, Mark; Sim, Ming Ann; Lim, Jimmy; Castañeda, Pablo; Green, Daniel W.; Fisher, Dale; Ti, Lian Kah; Murphy, Diarmuid; Hui, James

doi:10.2106/jbjs.20.00513

Cited by 42 publications

(43 citation statements)

References 51 publications

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“…Orthopaedic surgeons have a high responsibility both for them and for the staff and patients as they are leaders in a surgical team. Shortening of the operation time and avoidance of reaming are considered preventive factors in the orthopaedic surgery due to COVID-19 pandemic [11].…”

Section: Introductionmentioning

confidence: 99%

Influence of coronavirus disease 2019 pandemic state of emergency in orthopaedic fracture surgical treatment

Mitković

Bumbaširević

Milenković

et al. 2020

International Orthopaedics (SICOT)

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Purpose After the appearance of first COVID-19 cases in Serbia, state of emergency was declared on 15 March 2020 and lasted for 54 days. The aim of this report is to compare orthopaedic fracture frequencies in this period, when the walk was limited at the home mostly, with those during the same part in the previous year with regular state, thus to examine staying at home as a factor influencing the frequency of different fracture types. Methods There were 86 patients during the state of emergency in year 2020 and 106 patients during the same part of year 2019 with a regular state, having orthopaedic trauma surgery. Number of fractures, gender distribution, and age of patients have been compared between these periods. Results Total number of fractures decreased for about 19% during the state of emergency. There was nonsignificant difference in fracture frequency for all skeletal areas (p > 0.05), except for distal femoral fractures which occurred more often during the state of emergency (p < 0.05). Female ratio was higher during state of emergency than in regular state for femoral neck fractures. Conclusion Restricted going outside the home for 54 days has the influence in total number of fractures and gender distribution in femoral neck fractures. The method of external fixation used could be assumed as a reducing factor of intraoperative virus pandemic propagation among medical staff.

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Section: Introductionmentioning

confidence: 99%

Influence of coronavirus disease 2019 pandemic state of emergency in orthopaedic fracture surgical treatment

Mitković

Bumbaširević

Milenković

et al. 2020

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

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“…Although the relative vascularity of the spinal soft tissues effectively precludes the use of a scalpel blade in favor of a cutting diathermy, by keeping the sucker close to the diathermy tip, aerosolization can be minimized by eliminating as much of the aerosol as possible before it disperses [45]. It is advised that full PPE be worn by all operating room personnel during these aerosol generating procedures; further, it is recommended that these procedures be performed in facilities with high-efficiency particulate air filters and closed circuit ventilation [39,46,47].…”

Section: Challenges In Performing Spine Surgerymentioning

confidence: 99%

Addressing Coronavirus Disease 2019 in Spine Surgery: A Rapid National Consensus Using the Delphi Method via Teleconference

et al. 2020

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The magnitude and potential duration of the current coronavirus disease 2019 pandemic is something that most doctors currently in practice have yet to experience. While considerable information regarding COVID-19 is being published every day, it is challenging to filter out the most relevant or appropriate information for our individual practice. The Spine Society of Singapore convened via a teleconference on April 24, 2020 to collaborate on a national level and share collective wisdom in order to tackle the ongoing crisis. In the teleconference, 13 spine surgeons from across various hospitals in Singapore constituted the panel of experts.The following topics were discussed: repurposing of surgeons, continuity of spine services, introduction of telemedicine, triaging of spinal surgeries, preoperative testing, new challenges in performing spine surgery, and preparing for the post-pandemic era. While some issues required only the sharing of best practices, the Delphi panel method was adopted to form a consensus on others. Existing spine specific triage guidelines were debated and a locally accepted set of guidelines was established. Although preoperative testing is currently not performed routinely, the panel voted in favor of its implementation because they concluded that it is vital to protect themselves, their colleagues, and their patients. Solutions to operating room specific concerns were also discussed. This article reflects the opinions and insights shared during this meeting and reviews the evidence relevant to the issues that were raised. The rapid consensus reached during the teleconference has enabled us to be concerted, and thus stronger, in our national efforts to provide the best standard of care via our spine services in these challenging times. We believe that this article will provide some guidance for addressing COVID-19 in spine surgery and encourage other national/regional societies to conduct similar discussions that would help their navigation of this pandemic.

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“…First, "like-for-like" tissue is obtained from the same limb and can be performed under a sciatic or popliteal neuraxial block. This minimizes the risk of aerosolization from intubation during general anesthesia in a patient with an active COVID-19 infection [2]. Second, the surgical landmarks of this neurocutaneous flap are consistent and it can be raised quickly (Fig.…”

mentioning

confidence: 94%

“…Most surgical units are facing an acute shortage of resources, including workforce, anesthetic drugs, and operating facilities [1]. Despite the cancellation of elective procedures, orthopaedic surgeons continue to see limb-threatening conditions such as open fractures, severe infections, and fungating tumors [2]. Often, these patients are older and may have multiple comorbidities, and some may even have an ongoing or recent COVID-19 infection.…”

mentioning

confidence: 99%

Surgical Considerations in Patients with COVID-19

Cited by 42 publications

References 51 publications

Influence of coronavirus disease 2019 pandemic state of emergency in orthopaedic fracture surgical treatment

Influence of coronavirus disease 2019 pandemic state of emergency in orthopaedic fracture surgical treatment

Addressing Coronavirus Disease 2019 in Spine Surgery: A Rapid National Consensus Using the Delphi Method via Teleconference

Letter to the Editor: Can Sural Fasciocutaneous Flaps Be Effective in Patients Older Than 65?

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