Guidance Issued for Elective Orthopedic Surgery During COVID-19

Hospitals, health systems should consider SARS-CoV-2 prevalence, staffing, PPE before resuming schedule
surgeon with scalpel
surgeon with scalpel

MONDAY, July 20, 2020 (HealthDay News) -- In new guidelines from the International Consensus Group, published in the July 15 issue of The Journal of Bone & Joint Surgery, recommendations are presented for the reintroduction of elective orthopedic surgery during the COVID-19 pandemic.

Javad Parvizi, M.D., from the Rothman Orthopaedic Institute in Philadelphia, and colleagues developed recommendations based on the available scientific evidence for reintroduction of elective orthopedic surgical procedures, with a specific focus on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

The authors emphasize the importance of understanding which practices and protocols should be altered or implemented to minimize the risk for pathogen transfer during the SARS-CoV-2 pandemic. When determining how and when to implement recommendations, each hospital and health system should consider their unique situation in terms of SARS-CoV-2 prevalence, staffing capabilities, and personal protective equipment supply. Elective surgery may be resumed when lockdown has been lifted, the number of COVID-19 cases in the region has been consistently declining, the facility can admit non-COVID-19 patients to an area separate from COVID-19 patients, and the facility can maintain proper social distancing through the operative process. Prior to undergoing elective surgery, all patients should be screened for SARS-CoV-2; patients currently infected should not undergo elective surgery. Elective surgery should be risk-stratified and possibly deferred for patients at high risk for COVID-19.

"We realize that the situation is evolving on a daily basis and that some of the recommendations in the present report may need to be altered as new evidence emerges," the authors write.

Several authors disclosed financial ties to the medical device and other industries.

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