J Korean Med Assoc.  2021 Jul;64(7):491-498. 10.5124/jkma.2021.64.7.491.

Infection control in operating rooms for COVID-19 patients

• Lee SS
• Kim SJ
• Jung JE
• Kim GH
• Kwon MY
• Yun MJ

• KMID: 2518513
• DOI: http://doi.org/10.5124/jkma.2021.64.7.491

Abstract

Background
Surgeries performed for patients with coronavirus disease 2019 (COVID-19) place the medical staff at very high risk of infection. We suggest recommendations for appropriate operation preparation, anesthetic management, and infection control for COVID-19 patients in operating rooms.
Current Concepts
Surgeries must be performed in an airborne infection isolation room, such as a negative-pressure operating room. It is recommended that scheduled surgeries for COVID-19 patients be postponed to an acceptable extent, with the exception of emergency cases. Moreover, the number of medical staff participating in the surgery should be minimized. Medical staffs should practice proper hand hygiene and wear an appropriate level of personal protective equipment depending on the infection risk. While performing surgery and inducing anesthesia in COVID-19 patients, endotracheal intubation should be performed by trained anesthesiologists with a video laryngoscope, preferably using high-efficiency viral filters, which can prevent contamination in the anesthesia machine. Use of disposable equipment or COVID-19 patient-specific devices is recommended to prevent the spread of infection, but instruments that require sharing among multiple patients must be thoroughly cleaned and disinfected before their use for the next patient.
Discussion and Conclusion
Medical staff performing surgeries for COVID-19 patients are at very high risk of infection. Therefore, the use of appropriate personal protective equipment, high-efficiency viral filters in breathing circuits during anesthesia, and disinfection of contaminated equipment after the operation are mandatory.

Keyword

COVID-19; General surgery; Anesthesia; Operating rooms; Infection control; 코로나바이러스19; 수술; 마취; 수술실; 감염관리