J Yeungnam Med Sci.  2022 Jul;39(3):223-229. 10.12701/yujm.2021.01431.

Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study

• Kwak KH
• Kim JK
• Kwon KT
• Yeo J

• KMID: 2532075
• DOI: http://doi.org/10.12701/yujm.2021.01431

Abstract

Background
The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19–related surgical patients.
Methods
We reviewed the medical records of 118 COVID-19–related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19–related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results
One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of −11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19–related patients underwent emergent surgery in the negative-pressure room, including three COVID-19–confirmed patients and five COVID-19–exposed patients.
Conclusion
All surgeries of the COVID-19–related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

Keyword

COVID-19; Infection; Prevention; Surgery

Figure

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  Fig. 1. (A) Transfer route for coronavirus disease 2019 (COVID–19)-related patients. The red arrows show all pathways that were closed during COVID–19-related patient transfer. (B) Patient transfer using a portable isolation unit. All healthcare workers wore enhanced personal protective equipment, including overall clothes with headcover, shoe cover, goggles, surgical gloves, and powered air-purifying respirator. OR, operating room; ICU, intensive care unit.

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  Fig. 2. Ventilation system of the temporary, negative-pressure operating room. PRE, ____; V.D., volume damper; CMH, cubic meter per hour; HEPA, high-efficiency particulate air.

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