Table 3 COVID-19 surgical patients’ management

Key aspects in COVID-19 surgical patient management

All suspected or infected patients must be managed with the maximum attention.

All personnel in contact with the patient must wear PPE.

Transfers must be protected.

Infected patients must be moved as little as possible through the hospital.

Transfer routes must be precisely planned and be as short as possible.

The COVID operating area should be in a dedicated and possibly separate area.

COVID operating room must be dedicated and as close as possible to the entrance of the theater block.

Disposable material should be preferred.

Minimal material should be used for each intervention.

Transport personnel should be the same from transport origin to destination.

Once the patient has entered, the OR doors must be closed.

Operators (i.e., surgeon, anesthetist, nurses, technicians) should enter the OR in a timely manner to minimize exposure to infected patients.

Personnel involved in the intervention should not leave the OR during the procedure.

High OR air exchange cycles are recommended (> 25 exchanges/h).

Clinical documentation must remain outside the OR

At the end of each intervention all disposable materials must be disposed of and all surfaces and electromedical devices accurately cleaned and disinfected.

PPE must be removed and disposed of outside the OR in dedicated doffing areas ensuring the virus is not transmitted to the healthcare worker.

OR and surrounding donning/doffing areas must be sanitized as soon as possible after each procedure.

After each procedure, all involved personnel, whenever possible, should shower.

Recovery phase after surgery must be done in OR, before transfer the ward/ICU.