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The provision of a time-critical elective surgical service during the COVID-19 Crisis: a UK experience.
Burden, E G; Walker, R W; Ferguson, D J; Goubran, Amf; Howell, J R; John, J B; Khan, F; McGrath, J S; Evans, J P.
  • Burden EG; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • Walker RW; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • Ferguson DJ; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • Goubran A; University of Exeter Medical School, St Luke's Campus, Exeter, UK.
  • Howell JR; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • John JB; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • Khan F; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • McGrath JS; Royal Devon and Exeter Foundation Trust, Exeter, UK.
  • Evans JP; Royal Devon and Exeter Foundation Trust, Exeter, UK.
Ann R Coll Surg Engl ; 103(3): 173-179, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1073075
ABSTRACT

INTRODUCTION:

With the emergence of the COVID-19 pandemic, all elective surgery was temporarily suspended in the UK, allowing for diversion of resource to manage the anticipated surge of critically unwell patients. Continuing to deliver time-critical surgical care is important to avoid excess morbidity and mortality from pathologies unrelated to COVID-19. We describe the implementation and short-term surgical outcomes from a system to deliver time-critical elective surgical care to patients during the COVID-19 pandemic. MATERIALS AND

METHODS:

A protocol for the prioritisation and safe delivery of time-critical surgery at a COVID-19 'clean' site was implemented at the Nuffield Health Exeter Hospital, an independent sector hospital in the southwest of England. Outcomes to 30 days postoperatively were recorded, including unplanned admissions after daycase surgery, readmissions and complications, as well as the incidence of perioperative COVID-19 infection in patients and staff.

RESULTS:

A total of 128 surgical procedures were performed during a 31-day period by a range of specialties including breast, plastics, urology, gynaecology, vascular and cardiology. There was one unplanned admission and and two readmissions. Six complications were identified, and all were Clavien-Dindo grade 1 or 2. All 128 patients had preoperative COVID-19 swabs, one of which was positive and the patient had their surgery delayed. Ten patients were tested for COVID-19 postoperatively, with none testing positive.

CONCLUSION:

This study has demonstrated the implementation of a safe system for delivery of time-critical elective surgical care at a COVID-19 clean site. Other healthcare providers may benefit from implementation of similar methodology as hospitals plan to restart elective surgery.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Surgical Procedures, Operative / Elective Surgical Procedures / Time-to-Treatment / Neoplasms Type of study: Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7023

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Surgical Procedures, Operative / Elective Surgical Procedures / Time-to-Treatment / Neoplasms Type of study: Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Ann R Coll Surg Engl Year: 2021 Document Type: Article Affiliation country: Rcsann.2020.7023