Perspectives and Consensus among International Orthopaedic Surgeons during Initial and Mid-lockdown Phases of Coronavirus Disease.

Autor: Jerome JTJ; Department of Orthopedics, Hand and Reconstructive Microsurgery, Olympia Hospital and Research Centre, Tamil Nadu, India., Mercier F; Cl ínica Lambert Rua, Cordeiro Ferreira, Lisbon, Portugal., Mudgal CS; Harvard Medical School, Massachusetts, United States; Hand Surgery Services, Massachusetts General Hospital, Boston, Massachusetts, United States.; Hand Surgery Service, Massachusetts General Hospital, Boston, Massachusetts, United States., Arenas-Prat J; Department of Orthopaedics, ServeisMedics Penedes, Barcelona, Catalonia, Spain., Vinagre G; Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar., Goorens CK; Department of Orthopaedics, Regional Hospital Tienen, Tienen, Belgium., Rivera-Chavarría IJ; Servicio Vascular Periférico, Hospital Rafael Ángel Calderón Guardia, San José, Costa Rica., Sechachalam S; 11 Jalan Tan Tock Seng, Singapore., Mofikoya B; Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria., Thoma A; Dep artment of Orthopaedics, Hamilton, Ontario, Canada., Medina C; Department of Orthopaedics, Calle, Colombia., Rivera-Chavarría IJ; Servicio Vascular Periférico, Hospital Rafael Ángel Calderón Guardia, San José, Costa Rica., Henry M; Houston, Texas, United States., Afshar A; Department of Orthopedics, Imam Khomeini hospital, Urmia University of Medical Sciences, Urmia, Iran., Dailiana ZH; Department of Orthopaedic Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece., Prasetyono TOH; Department of Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia., Artiaco S; Orthopaedic and Trauma Center, CTO, Turin, Italy., Madhusudhan TR; Glan Clwyd Hospital, Bodelwyddan, North wales, United Kingdom., Ukaj S; Veternik, Prishtine, Republic of Kosovo., Reigstad O; Hand Surgery Unit, Oslo University Hospital, Oslo, Norway., Hamada Y; Hand Surgery Unit, Kansai Medical University Medical Center, Moriguchi City, Osaka, Japan., Bedi R; Fourth Avenue De nistone, Australia., Poggetti A; Hand and Reconstructive Microsurgery Unit, AOU Careggi, Florence, Italy., Al-Qattan MM; Riyadh, Saudi Arabia., Siala M; Service d'Orthopedie, chu de purpan, Toulouse, France., Viswanathan A; United Kingdom., Romero-Reveron R; Trauma and Orthopaedic Departamento, Centro Médico Docente La Trinidad, Caracas, Venezuela., Hong JP; Hand and Reconstructive Microsurgery Unit, Asan Medical Center, Songpagu Seoul, Korea., Khalid KA; Department of Orthopedics, IIUM Medical Centre, Jalan Sultan Ahmad Shah, Kuantan, Pahang, Malaysia., Bhaskaran S; Iyer Orthopaedic Centre, Solapur, Maharashtra, India., Venkatadass K; Department of Pediatric Orthopaedics, India., Leechavengvongs S; Department of Orthopaedics, Vichaiyut Hospital, Bangkok, Thailand., Goorens CK; School of Medicine, China Medical University, Taichung, Taiwan., Nazim S; Department of Orthopaedics, Algiers Faculty of Medicine, Algiers, Algeria., Georgescu AV; Clinical Hospital for Rehabilitation, University of Medicine Iuliu Hatieganu, Cluj Napoca, Cluj-Napoca, Romania., Tremp M; Department of Orthopaedics, Dorfplatz 1, Cham, Switzerland., Nakarmi KK; Kirtipur Hospital, Kathmandu, Nepal., Ellabban MA; Plastic and Reconstructive Surgery Unit, Department of Surgery, Faculty of Medicine, Suez Canal University, Egypt., Chan P; Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Tuen Mun, Hong Kong., Aristov A; Department of Orthopaedics, Krasnodar, Russia., Patel S; Hamilton, New Zealand., Moreno-Serrano CL; Bogota, Colombia., Rai S; Madhaw Market Lanka, Uttar Pradesh, India., Kanna RM; Coimbatore, India., Malshikare VA; 18.52 North Hand and Wrist Hospital, Pune, Maharashtra, India., Tanabe K; Department of Orthopaedics, Nishinomiya Municipal Central Hospital, Hayashidacho, Nishinomiya, Japan., Thomas S; Department of Ort hopaedics, Rohini, Delhi, India., Gokkus K; Alanya Research and Practice Center, Baskent University School of Medicine, Saray Mah, Antalya, Turkey., Baek SH; Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea., Brandt J; HandCenter, Öresund, Baltzarsgatan Malmö, Sweden., Rith Y; Department of Orthopaedics, Cambodia., Olazabal A; Department of Orthopaedics, CABA, Buenos Aires, Argentina., Saaiq M; Department of Hand Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan., Patil V; Orthopedics, Hand and Microsurgery Unit, Basildon Unive rsity Hospital, Basildon, Essex, United Kingdom., Jithendran N; Bommanhalli, Bangalore, Karnataka, India., Parekh H; Orthopaedic Speciality Hospital, Rajkot, Gujarat, India., Minamikawa Y; Hand Unit, Namba Hand Centre, Osaka, Japan., Atagawi AA; GhotAlshaal, Tripoli, Libya., Hadi JA; Department of Orthopaedics, Amman, Jordan., Berezowsky CA; Av. Vasco De Quiroga, México., Moya-Angeler J; Department of Orthopaedics, Murcia, Spain., Altamirano-Cruz MA; Department of Orthopaedics, Mexico, Spain., Galvis R LA; Bogota, Santa Barbara, Mexico., Antezana A; Calle Tomasbfrias, Boliva., Paczesny L; Orvit Clinic, Citomed Healthcare Center, Sklodowskiej, Torun, Poland., Fernandes CH; Avenida Le oncio de Magalhaes, Sao Paulo, Brazil., Asadullah M; Orthopedics and Hand surgery Unit, Eman Medical College Hospital, Savar, Dhaka, Bangladesh., Yuan-Shun L; Taiwan, China., Makelov B; Department of Orthopaedics, Stara Zagora, Bulgaria., Dodakundi C; Department of Orthopaedics, Rashid Hospital, Dubai, United Arab Emirates., Regmi R; Department of Orthopedics and Reconstructive Microsurgery, National Trauma Centre, Kathmandu, Nepal., Pereira GU; Urbcapillune s/n San Francisco Moquegua, Peru., Zhang S; Department of Spine and Bone Tumor Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China., Sayoojianadhan B; Hand and Reconstructive Microsurgery Unit, Department of Orthopedic Surgery, St James Hospital, Chalakudy, Kerala, India., Callupe I; Avenida Sanchez Carrion, Lima, Peru., Rakha MI; Orthopedic Department, Suez Canal university hospital, Ismailia, Egypt., Papes D; Department of surgery (Ped and Vasc), University Hospital Center Zagreb, Zagreb, Croatia., Ganesan RP; Department of Orthopedics, KAP Viswanatham Government Medical College, Trichy, India., Mohan M; Trichy, Tamil Nadu, India., Jeyaraman A; 2 Chandraganthi Nagar, Bypass Road, Madurai. India., Prabhakar P; Orthopaedics and Joint Replacement Care Hospitals, Nampally Hyderabad, India., Rajniashokan A; 2A Jeyam Paradise, State Bank Officers Colony, Cantonment, Trichy, India., Geethan I; Trichy, Tamil Nadu, India., Chandrasekar S; Salem, Tamil Nadu, India., Löw S; Clinic for Trauma and Hand Surgery, Bad Mergentheim, Germany., Thangavelu K; Radha Medical Centre, Erode, Tamil Nadu, India., Giudici LD; Ortopedia e Traumatologia, Chirurgiaarticolare di Spalla e Ginocchio, Albodei Medici e Chirurghi di Latina, Cagliari, Italy., Palanisamy Y; Ortho One Orthopedic Speciality Hospital, Coimbatore, Tamil Nadu, India., Vaidyanathan S; Department of Orthopaedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, India., Boretto J; Ciudad Autonoma de Buenos Aires, Argentina., Ramirez MA; Bucaramanga, Santander, Colombia., Goundar TS; Department of Orthopedics, Joint Replacement Surgery Unit, KMCH H ospitals, Coimbatore, Tamil Nadu, India., Kuppusamy T; Department of Orthopedics, Trauma and Joint Replacement, Shri Bharani Hospital, Villupuram, Tamil Nadu, India., Kanniyan K; AJRI, SIMS Hospitals No 1, Chennai, Tamil Nadu, India., Srivastava A; Agra, Uttar Pradesh, India., Chiu YC; Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan., Bhat AK; Department of Orthopaedics, KMC, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India., Gopinath NR; Department of Orthopedics, Thoothukudi Medical College, India., Vasudevan VP; Department of Orthopaedics, SRM Medical College, Chennai, Tamil Nadu, India., Abraham V; Department of Orthopaedics, Mahatma Gandhi Medical College, Pondicherry, India.
Jazyk: angličtina
Zdroj: Journal of hand and microsurgery [J Hand Microsurg] 2020 Dec; Vol. 12 (3), pp. 135-162. Date of Electronic Publication: 2020 Jul 06.
DOI: 10.1055/s-0040-1713964
Abstrakt: With a lot of uncertainty, unclear, and frequently changing management protocols, COVID-19 has significantly impacted the orthopaedic surgical practice during this pandemic crisis. Surgeons around the world needed closed introspection, contemplation, and prospective consensual recommendations for safe surgical practice and prevention of viral contamination. One hundred orthopaedic surgeons from 50 countries were sent a Google online form with a questionnaire explicating protocols for admission, surgeries, discharge, follow-up, relevant information affecting their surgical practices, difficulties faced, and many more important issues that happened during and after the lockdown. Ten surgeons critically construed and interpreted the data to form rationale guidelines and recommendations. Of the total, hand and microsurgery surgeons (52%), trauma surgeons (32%), joint replacement surgeons (20%), and arthroscopy surgeons (14%) actively participated in the survey. Surgeons from national public health care/government college hospitals (44%) and private/semiprivate practitioners (54%) were involved in the study. Countries had lockdown started as early as January 3, 2020 with the implementation of partial or complete lifting of lockdown in few countries while writing this article. Surgeons (58%) did not stop their surgical practice or clinics but preferred only emergency cases during the lockdown. Most of the surgeons (49%) had three-fourths reduction in their total patients turn-up and the remaining cases were managed by conservative (54%) methods. There was a 50 to 75% reduction in the number of surgeries. Surgeons did perform emergency procedures without COVID-19 tests but preferred reverse transcription polymerase chain reaction (RT-PCR; 77%) and computed tomography (CT) scan chest (12%) tests for all elective surgical cases. Open fracture and emergency procedures (60%) and distal radius (55%) fractures were the most commonly performed surgeries. Surgeons preferred full personal protection equipment kits (69%) with a respirator (N95/FFP3), but in the case of unavailability, they used surgical masks and normal gowns. Regional/local anesthesia (70%) remained their choice for surgery to prevent the aerosolized risk of contaminations. Essential surgical follow-up with limited persons and visits was encouraged by 70% of the surgeons, whereas teleconsultation and telerehabilitation by 30% of the surgeons. Despite the protective equipment, one-third of the surgeons were afraid of getting infected and 56% feared of infecting their near and dear ones. Orthopaedic surgeons in private practice did face 50 to 75% financial loss and have to furlough 25% staff and 50% paramedical persons. Orthopaedics meetings were cancelled, and virtual meetings have become the preferred mode of sharing the knowledge and experiences avoiding human contacts. Staying at home, reading, and writing manuscripts became more interesting and an interesting lifestyle change is seen among the surgeons. Unanimously and without any doubt all accepted the fact that COVID-19 pandemic has reached an unprecedented level where personal hygiene, hand washing, social distancing, and safe surgical practices are the viable antidotes, and they have all slowly integrated these practices into their lives. Strict adherence to local authority recommendations and guidelines, uniform and standardized norms for admission, inpatient, and discharge, mandatory RT-PCR tests before surgery and in selective cases with CT scan chest, optimizing and regularizing the surgeries, avoiding and delaying nonemergency surgeries and follow-up protocols, use of teleconsultations cautiously, and working in close association with the World Health Organization and national health care systems will provide a conducive and safe working environment for orthopaedic surgeons and their fraternity and also will prevent the resurgence of COVID-19.
Competing Interests: NoteConflict of Interest The views expressed in this article are those of the authors and do not represent the official policy of the any country. None declared.
(Society of Indian Hand & Microsurgeons. This article is published by Thieme.)
Databáze: MEDLINE
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