Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;107(10):1262-1280.
doi: 10.1002/bjs.11750.

Personal protective equipment for surgeons during COVID-19 pandemic: systematic review of availability, usage and rationing

Z M Jessop  1   2 , T D Dobbs  1   2 , S R Ali  1   2 , E Combellack  1   2 , R Clancy  2 , N Ibrahim  1   2 , T H Jovic  1   2 , A J Kaur  2 , A Nijran  2 , T B O'Neill  2 , I S Whitaker  1   2
Affiliations

Personal protective equipment for surgeons during COVID-19 pandemic: systematic review of availability, usage and rationing

Z M Jessop et al. Br J Surg. 2020 Sep.

Abstract

Background: Surgeons need guidance regarding appropriate personal protective equipment (PPE) during the COVID-19 pandemic based on scientific evidence rather than availability. The aim of this article is to inform surgeons of appropriate PPE requirements, and to discuss usage, availability, rationing and future solutions.

Methods: A systematic review was undertaken in accordance with PRISMA guidelines using MEDLINE, Embase and WHO COVID-19 databases. Newspaper and internet article sources were identified using Nexis. The search was complemented by bibliographic secondary linkage. The findings were analysed alongside guidelines from the WHO, Public Health England, the Royal College of Surgeons and specialty associations.

Results: Of a total 1329 articles identified, 95 studies met the inclusion criteria. Recommendations made by the WHO regarding the use of PPE in the COVID-19 pandemic have evolved alongside emerging evidence. Medical resources including PPE have been rapidly overwhelmed. There has been a global effort to overcome this by combining the most effective use of existing PPE with innovative strategies to produce more. Practical advice on all aspects of PPE is detailed in this systematic review.

Conclusion: Although there is a need to balance limited supplies with staff and patient safety, this should not leave surgeons treating patients with inadequate PPE.

PubMed Disclaimer

Figures

Graphical Abstract
Graphical Abstract
Fig. 1
Fig. 1
Flow diagram showing selection of articles for review
Fig. 2
Fig. 2
Personal protective equipment required in different surgical environments during COVID-19 pandemic
Fig. 3
Fig. 3
Types of face mask and their relative risk reduction
Fig. 4
Fig. 4
Percentage particles filtered (0·01–1 μm diameter) with different types of face mask
See this image and copyright information in PMC

Comment in

References

    1. Zhou P, Yang X-L, Wang X-Get al. . Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin. BioRxiv 2020; 33: 914952.
    1. WHO . Coronavirus Disease (COVID-19) Pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019 [accessed 22 April 2020].
    1. Ferguson N, Laydon D, Nedjati-Gilani Get al. . Report 9: impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College COVID-19 Response Team (16-03-20) 2020; 1–20.
    1. Wong S, Vaughan A, Quilty-Harper C, Liverpool L. Coronavirus Latest – New Interventions Saved 59 000 Lives in 11 Countries. https://www.newscientist.com/article/2237475-coronavirus-latest-interven... [accessed 30 March 2020].
    1. Spinelli A, Pellino G. COVID-19 pandemic: perspectives on an unfolding crisis. Br J Surg 2020; 10.1002/bjs.11627 [Epub ahead of print]. - DOI - PMC - PubMed

Publication types