Vol 35 | Issue 2 | May-Aug 2020 | page: 53-61 | Sandeep Kumar¹, Rajesh Arora¹, Arvind Kumar¹, Surabhi Vyas², Shilpee Kumar³, Priyanka Arora⁴, Owais Ahmed Qureshi¹, Javed Jameel¹
Authors: Sandeep Kumar¹, Rajesh Arora¹, Arvind Kumar¹, Surabhi Vyas², Shilpee Kumar³, Priyanka Arora⁴, Owais Ahmed Qureshi¹, Javed Jameel¹
¹Department of Orthopaedics, Hamdard Institute of Medical Sciences & Research, New Delhi, India
²Department of Radiodiagnosis, AIIMS, New Delhi, India
³Department of Microbiology, VMMC & Safdarjung Hospital, New Delhi, India
⁴Department of Obstetrics & Gynaecology, ESIC Medical College, Faridabad, Haryana, India
Address of Correspondence:
Dr. Rajesh Arora
Hamdard Institute of Medical Sciences & Research, New Delhi, India
Background: SARS-Cov-2 is believed to have infected over two million humans to date. Lack of complete knowledge about the epidemiology of this virus and doubts about perioperative management of orthopedic patients is further curtailing patient care. This review article discusses the pertinent virology and relevant precautionary practices that help in reducing the risk of contamination of health care workers from an orthopedic point of view.
Methodology: The review was prepared by authors belonging to different disciplines of health care. Recent PubMed-based literature and national and international guidelines related to the CoViD-19 pandemic and its implications on orthopedic practice were reviewed.
Result: Elective surgeries should be avoided. All patients undergoing surgical procedures should be CoViD-19 tested whenever possible. CT chest may be used as a screening tool when CoViD-19 testing is not available considering the risk of exposure to healthcare workers and setup; and higher perioperative mortality (if the patient tests positive later). A full personal protection kit should be used in all surgical cases. Aerosol generating procedures should be avoided. Safety measures should be taken during the shifting of patients to prevent contamination of health care setup and workers. Biowaste from the CoViD zone should be properly segregated and well labeled.
Conclusion: Orthopaedic surgeons should be well updated about the CoViD-19 disease, and should help and support regional policies for both containment and mitigation measures. Simultaneously, one should triage his/her patients in order to use available resources with maximal efficiency without contaminating other patients, healthcare setup and its workers.
Keywords: Orthopaedic surgery; CoViD-19; Pandemic; Perioperative management; Aerosol generating procedures (AGPs), SARS-CoV-2, Orthopaedic trauma, Personal Protective Equipment (PPE), Preoperative workup; Postoperative management.
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|How to Cite this Article: Kumar S, Arora R, Kumar A, Vyas S, Kumar Shilpee, Arora P, Qureshi O A, Jameel J | Problems and solutions for orthopedic surgeons during COVID-19 pandemic. | Journal of Bone and Joint Diseases | May-Aug 2020;35(2): 53-61.|