Panamerican Journal of Trauma, Critical Care & Emergency Surgery

Register      Login

VOLUME 9 , ISSUE 2 ( May-August, 2020 ) > List of Articles

PERSPECTIVE

COVID-19 Pandemic Acute-care Surgery Practice Survey Results from the Panamerican Trauma Society International Trauma Tele-Grand Rounds

C Rodrigo Olvera, Antonio Marttos, Rishi Rattan, Daniel D Yeh, Patricia M Byers, Gabriel Ruiz, Shevonne S Satahoo, Enrique Ginzburg, Nicholas Namias, Gerd D Pust

Citation Information : Olvera CR, Marttos A, Rattan R, Yeh DD, Byers PM, Ruiz G, Satahoo SS, Ginzburg E, Namias N, Pust GD. COVID-19 Pandemic Acute-care Surgery Practice Survey Results from the Panamerican Trauma Society International Trauma Tele-Grand Rounds. Panam J Trauma Crit Care Emerg Surg 2020; 9 (2):158-161.

DOI: 10.5005/jp-journals-10030-1283

License: CC BY-NC 4.0

Published Online: 03-09-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: As of June 9, 2020, the coronavirus disease 2019 (COVID-19) pandemic has affected more than 7 million people worldwide, causing more than 400,000 deaths. Acute-care surgery approaches in times of the COVID-19 pandemic were discussed during the Panamerican Trauma Society International Trauma Tele-Grand Rounds meeting in April 27, 2020. The purpose of this study is to identity practice patterns among surgeons treating acute surgical diseases during the pandemic. Materials and methods: COVID-19 epidemiology, prevalence in surgical patients, and treatment options of patients with acute surgical diseases in the presence of SARS-CoV-2-positive status were discussed. An electronic audience response system was used to assess opinions and practice patterns of the participating surgeons. Deidentified data collection was performed, stored, and subsequently analyzed using Excel software 2018. Results: The conference was attended by 91 participants from 20 countries. Forty-six surgeons participated in the survey, with 36% practising at a hospital with >80 active COVID-19 inpatients. Forty-eight percent of the participating surgeons had provided surgical care for SARS-CoV-2-positive (CoV+) patients. At the time of provider–patient interaction, 58% of surgeons were not aware of the CoV+ status. Surgeons reported changing practice patterns during the pandemic. They would treat CoV+ patients with acute cholecystitis with antibiotics only (64%), IR drain (12%), laparoscopic-(5%), open cholecystectomy (12%), and no opinion (7%). For acute appendicitis, 57% of surgeons favor antibiotics only vs open-(29%), laparoscopic appendicectomy (10%), and no opinion (4%). Gas/smoke-filtering systems for laparoscopy were available only to 14% of respondents. SARS-CoV-2 screening protocols utilize one RNA real-time polymerase chain reaction (RT-PCR) (29%), two RNA-RT-PCR 72 hours apart (7%), and IgG/IgM plus RNA RT-PCR (17%); 17% have no screening capacities. Conclusion: Standard acute-care surgery practice patterns changed favoring nonoperative treatment. Testing protocols vary among healthcare systems. Further studies are needed to understand the impact of the COVID-19 pandemic on outcomes in acute-care surgery patients.


PDF Share
  1. COVID-19 United States Cases By County 2020. Johns Hopkins University of Medicine https://coronavirus.jhu.edu/us-map.
  2. Corporation M. Microsoft Excel. 2018.
  3. Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis 2020. ciaa344. DOI: 10.1093/cid/ciaa344.
  4. Hansson J, Körner U, Khorram-Manesh A, et al. Randomized clinical trial of antibiotic therapy vs appendicectomy as primary treatment of acute appendicitis in unselected patients. Br J Surg 2009;96(5): 473–481. DOI: 10.1002/bjs.6482.
  5. Di Saverio S, Sibilio A, Giorgini E, et al. The NOTA study (non operative treatment for acute appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis. Ann Surg 2014;260(1):109–117. DOI: 10.1097/SLA.0000000000000560.
  6. Salminen P, Paajanen H, Rautio T, et al. Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial. JAMA 2015;313(23):2340–2348. DOI: 10.1001/jama.2015.6154.
  7. Sanduzzi A, Zamparelli SS. Nasopharyngeal and oropharyngeal swabs, and/or serology for SARS COVID-19: what are we looking for? Int J Environ Res Public Health 2020;17(9):3289. DOI: 10.3390/ijerph17093289.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.