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Instituting a Green Zone for Elective Surgery During the Second Wave of COVID-19.

Authors :
Iqbal MR
Subramonian S
Matwala K
Morrison C
Karamanakos S
Haque SU
Chicken DW
Lovett B
Walton SJ
Source :
Cureus [Cureus] 2021 Nov 15; Vol. 13 (11), pp. e19584. Date of Electronic Publication: 2021 Nov 15 (Print Publication: 2021).
Publication Year :
2021

Abstract

Objective Elective surgery came to a standstill during the first wave of COVID-19. The safe resumption of elective surgery with COVID-19 prevalent in the community remains a significant challenge. The aim of this study was to look into the outcomes of elective general surgery in a dedicated 'Green Zone (GZ)' during the second wave of COVID-19 in the United Kingdom. Method A 'Green Zone' pathway, meant to provide a COVID-free environment, was created. A retrospective review of prospectively collected data was done on consecutive patients who underwent an elective general surgical procedure at a single NHS trust over a six-month period (September 1, 2020, to February 28, 2021). The primary outcome was 30-day COVID-19 mortality. Secondary outcomes included 30-day non-COVID-19 mortality, readmissions, and complications. Results The study included 331 patients with a median age of 55 years (interquartile range, IQR, 41-67); 169 (51%) were females. The majority of the patients were American Society of Anaesthesiologists grade 2 (ASA 2; n=177, 53%) followed by ASA 3 (n=76, 23%). Forty-seven patients (14%) had been shielding earlier in the year. Most of the cases were day cases (n=224, 67%). There was no 30-day COVID-19 or non-COVID-19 mortality. One patient developed COVID-19 three weeks after the index operation. Thirty-day readmission and complication rate were 4% (n=14) and 6% (n=21). Most of the complications were Clavien-Dindo grade 2 (n=10, 3%) followed by an equal number of grades 1 and 3b (n=5, 1.5%). Conclusion This study has shown that a dedicated 'Green Zone' elective operating pathway is safe and feasible provided a balanced risk assessment approach is adopted.<br />Competing Interests: The authors have declared that no competing interests exist.<br /> (Copyright © 2021, Iqbal et al.)

Details

Language :
English
ISSN :
2168-8184
Volume :
13
Issue :
11
Database :
MEDLINE
Journal :
Cureus
Publication Type :
Academic Journal
Accession number :
34926055
Full Text :
https://doi.org/10.7759/cureus.19584