[Resource requirements in the surgical treatment of COVID­19 patients at a university clinic of maximum care]. / Ressourcenbedarf bei der chirurgischen Behandlung von COVID­19-Patienten in der universitären Maximalversorgung.

ABSTRACT

BACKGROUND: Surgical procedures in patients suffering from coronavirus disease 2019 (COVID­19) are possible under strict hygiene and protective measures and are currently carried out regularly. This study examined how much additional work this involves. MATERIAL AND METHODS: A structured evaluation of 71 surgical procedures performed at the Augsburg University Hospital between 1 November 2020 until 31 December 2020 was carried out. The operations on COVID­19 patients were compared to procedures on non-COVID­19 patients with respect to temporal, structural and staff resources, exemplified by four interventions: transbrachial embolectomy, total hip arthroplasty (H-TEP), proximal femoral nail antirotation (PFN-A) and new implantations of cardiac pacemakers. RESULTS: The incision to suture times between the interventions in patients with COVID­19 and non-COVID­19 patients did not show any significant differences in any of the four interventions evaluated. The postoperative monitoring in the operating room, which is identified as time-consuming in many interventions, was often circumvented by postoperative transfer to the intensive care unit or by the use of local anesthetic procedures. For major operations, such as H­TEP, the preparation time was shown to be significantly longer (p = 0.037). Furthermore, there was a significantly higher requirement for anesthesia nursing personnel of 1.5 vs. 1.0 (p = 0.02). CONCLUSION: A quantification of the additional effort of operative treatment is difficult due to the already complex care of COVID­19 patients; however, it can be assumed that there is an increased need for additional human and structural resources due to the supply of material from outside the operating room, which is not documented in the standard recording.