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Abstract
in English, Spanish

Background: Surgeons urgently need guidance on how to deliver surgical services safely and effectively during the COVID-19 pandemic. The aim was to identify the key domains that should be considered when developing pandemic preparedness plans for surgical services.

Methods: A scoping search was conducted to identify published articles relating to management of surgical patients during pandemics. Key informant interviews were conducted with surgeons and anaesthetists with direct experience of working during infectious disease outbreaks, in order to identify key challenges and solutions to delivering effective surgical services during the COVID-19 pandemic.

Results: Thirteen articles were identified from the scoping search, and surgeons and anaesthetists representing 11 territories were interviewed. To mount an effective response to COVID-19, a pandemic response plan for surgical services should be developed in advance. Key domains that should be included are: provision of staff training (such as patient transfers, donning and doffing personal protection equipment, recognizing and managing COVID-19 infection); support for the overall hospital response to COVID-19 (reduction in non-urgent activities such as clinics, endoscopy, non-urgent elective surgery); establishment of a team-based approach for running emergency services; and recognition and management of COVID-19 infection in patients treated as an emergency and those who have had surgery. A backlog of procedures after the end of the COVID-19 pandemic is inevitable, and hospitals should plan how to address this effectively to ensure that patients having elective treatment have the best possible outcomes.

Conclusion: Hospitals should prepare detailed context-specific pandemic preparedness plans addressing the identified domains. Specific guidance should be updated continuously to reflect emerging evidence during the COVID-19 pandemic.

Antecedentes: Los cirujanos necesitan urgentemente disponer de guías de cómo pueden realizar su trabajo con seguridad y de forma efectiva durante la pandemia de COVID-19. Nuestro objetivo fue identificar los puntos clave que deberían tener en cuenta los servicios quirúrgicos en el momento de desarrollar un protocolo ante la pandemia. MÉTODOS: Se realizó una búsqueda del tema para identificar los artículos publicados relacionados con el manejo de pacientes quirúrgicos durante pandemias. Además, se realizaron entrevistas a cirujanos y anestesistas con experiencia directa durante brotes de enfermedades infecciosas para obtener información e identificar los retos clave y las soluciones para proporcionar servicios quirúrgicos efectivos durante la pandemia de COVID-19.

Resultados: Se identificaron 13 artículos y se entrevistó a cirujanos y anestesistas de 11 territorios. Con el fin de organizar una respuesta efectiva a la COVID-19, se debe disponer de antemano de un plan de respuesta para los servicios quirúrgicos ante una pandemia. Los puntos clave que debe incluirse en este plan son: proporcionar formación al personal (por ejemplo, traslado de pacientes, colocación y retirada de equipos de protección personal; reconocer y tratar la infección por COVID-19); medidas de soporte de todo el hospital ante la COVID-19 (reducción de actividades clínicas, endoscópicas o de cirugía electiva no urgente); establecimiento de equipos mixtos de atención en urgencias; reconocimiento y tratamiento la infección por COVID-19 en pacientes de urgencias y en pacientes postoperados. Al final de la pandemia de COVID-19 es inevitable la acumulación de procedimientos retrasados y los hospitales deben planificar cómo abordar esta situación de forma efectiva para garantizar que los pacientes electivos tengan los mejores resultados posibles. CONCLUSIÓN: Los hospitales deberían preparar planes detallados ante una pandemia que aborden los puntos clave señalados. Estos planes deben actualizarse continuamente ante las nuevas evidencias que surjan durante la pandemia de COVID-19.

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Figures

Graphical Abstract
Graphical Abstract
Fig. 1
Fig. 1
Territories represented by participants in the guidance development group
See this image and copyright information in PMC

Comment in

  • The show must go on.
    Nguyen TK, Chua D, Shannon NB, Ng JCF, Tan HK. Nguyen TK, et al. Br J Surg. 2020 Jun;107(7):e201. doi: 10.1002/bjs.11684. Epub 2020 May 8. Br J Surg. 2020. PMID: 32383160 Free PMC article. No abstract available.

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