Surgery in times of COVID-19-recommendations for hospital and patient management

Abstract

Background: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has escalated rapidly to a global pandemic stretching healthcare systems worldwide to their limits. Surgeons have had to immediately react to this unprecedented clinical challenge by systematically repurposing surgical wards.

Purpose: To provide a detailed set of guidelines developed in a surgical ward at University Hospital Wuerzburg to safely accommodate the exponentially rising cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological patients or jeopardizing the well-being of hospital staff.

Conclusions: The dynamic prioritization of SARS-CoV-2 infected and surgical patient groups is key to preserving life while maintaining high surgical standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and operating areas prevents viral spread while adequately training and carefully selecting hospital staff allow them to confidently and successfully undertake their respective clinical duties.

Keywords: COVID-19; SARS-CoV-2; Surgery.

Fig. 1

Structure and structuring of the surgical SARS-CoV-2 bedside unit (modified from construction drawing of “Zentrum für Operative Medizin, University Hospital Wuerzburg”), which is divided into 3 areas: infectious area (red), for SARS-CoV-2 positive patients, potentially infectious area (yellow) for suspected patients with SARS-CoV-2 and the clean area (green). Patient access is controlled via the semi-infectious area. There is separate access to the station for medical staff to enter the clean station area directly