A survey among physicians in surgery and anesthesiology departments after the first surge of SARS-CoV-2 infections in Germany : Preparing for further challenges ahead.

BACKGROUND: The SARS-CoV­2 pandemic has extensively challenged healthcare systems all over the world. Many elective operations were postponed or cancelled, changing priorities and workflows in surgery departments. AIMS: The primary aim of this cross-sectional study was to assess the workload and psychosocial burden of surgeons and anesthesiologists, working in German hospitals during the first wave of SARS-CoV­2 infections in 2020. METHODS: Quantitative online survey on the workplace situation including psychosocial and work-related stress factors among resident and board-certified surgeons and anesthesiologists. Physicians in German hospitals across all levels of healthcare were contacted via departments, professional associations and social media posts. RESULTS: Among 154 total study participants, 54% of respondents stated a lack of personal protective equipment in their own wards and 56% reported increased staff shortages since the onset of the pandemic. While routine practice was reported as fully resumed in 71% of surgery departments at the time of the survey, work-related dissatisfaction among responding surgeons and anesthesiologists increased from 24% before the pandemic to 36% after the first wave of infections. As a countermeasure, 94% of participants deemed the establishment of action plans to increase pandemic preparedness and strengthening German public health systems a useful measure to respond to current challenges. CONCLUSION: The aftermath of the first wave of SARS-CoV­2 infections in Germany has left the surgical staff strained, despite temporarily decreased workloads. Overall, a critical review of the altered conditions is indispensable to identify and promote effective solutions and prudent action plans required to address imminent challenges.

O33 TREATMENT OF INCARCERATED GROIN HERNIA - EMERGING EVIDENCE BASED ON THE SWEDISH HERNIA REGISTER

Aim The evidence base for statements about risk factors, morbidity and mortality for emergency hernia repair is mostly low quality. The aim of this study is to elucidate risk factors for the development of incarcerated hernia and outcome after adult emergency hernia repair using data from the Swedish Hernia Register (SHR). Material and Methods Data in this observational study were extracted from the SHR. It included registered cases between January 1, 2009 and December 31, 2019. Maximal follow-up was until December 31, 2020. Demographic data were analysed descriptively, risk analyses were performed using multivariate- and Cox-regression models. Results A total of 164.844 cases could be included after application of the in- and exclusion criteria. Women [odds ratio (OR) 1.42 99%CI 1.32–1.51], patients with lateral hernia [OR 1.54, 99%CI 1.47–1.61], femoral hernia [OR 14.63, 99%CI 13.32–16.06] and hernia recurrence [OR 2.46, 99%CI 2.33–2.60] were at higher risk of developing an incarcerated hernia. The highest strangulation risk was seen among women [OR 2.36, 99%CI 1.91–2.90], femoral hernia [OR 7.00, 99%CI 5.40–9.11] and recurrent hernia [1.90, 99%CI 1.54–2.33]. Patients with hernia incarceration or strangulation suffer significantly more frequent from postoperative complications [16.7% and 40.9% respectively, both p < 0.001]. Conclusions The data demonstrate that certain risks groups exist, which are prone to suffer from hernia incarceration and strangulation. These at risk patients should be prioritized, especially during the reorganisation of services to cope with the massive surgical backlog in the aftermath of the COVID-19 pandemic.