key: cord-0811639-b41hmv7w
authors: Presl, J.; Weitzendorfer, M.; Varga, M.; Kryeziu, H.; Ciftci, S.; Borhanian, K.; Emmanuel, K.; von Rahden, B. H. A.
title: The COVID Surgery Service (CSS) within the Salzburg COVID‐Emergency Plan (SCEP)
date: 2020-05-23
journal: Br J Surg
DOI: 10.1002/bjs.11682
sha: 6fb4d842378818d17a7a52952d1db7b932c169a0
doc_id: 811639
cord_uid: b41hmv7w

nan

The COVID-19-pandemic is currently challenging surgical services 1,2 . An increasing number of surgical patients have a suspicion or proof of SARS-CoV-2 infection 2,3 . A specialized COVID Surgery Service (CSS) and split team structure (2 teams of specialists with complementing expertise) for non-COVID cases has been established in our institution. This structure was designed so that alternating teams would remain in the case of temporary quarantine of one team. The CSS is part of a newly established COVID clinic that has a triage unit, outpatient department, separate wards for suspected and confirmed COVID cases, three ICUs (with 81 beds for mechanical ventilation and 5 extracorporeal membrane oxygenation (ECMO) machines) and three operating theatres. A mobile CT scanner unit was assembled close to the CSS as thoracic imaging of patients suspected of having COVID-19 is considered crucial 1 .

Suggestions regarding personal protective equipment (PPE) during surgical operations and endoscopy procedures are emerging rapidly, but there are no unequivocally accepted standards as yet 3 . Some operations and endoscopy procedures are regarded as aerosolproducing procedures with an increased risk of infection for involved medical staff. Therefore, a face shield, European Union (EU) standard FFP3 mask (equivalent to a US National Institute for Occupational Safety and Health N99-certified mask), waterproof gown and double gloves are provided. The decision regarding type of surgery (open versus laparoscopic) is left to the surgeon on duty. It is unclear whether a laparoscopic procedure increases the risk for infection with SARS-CoV-2. Accumulated smoke may enter the atmosphere at deflation of the pneumoperitoneum so a filtration system (active or passive) is included as standard 4 .

surgical service

COVID-19 pandemic: perspectives on an unfolding crisis

Global guidance for surgical care during the COVID-19 pandemic

Safe management of surgical smoke in the age of COVID-19