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Published in: World Journal of Surgery 9/2020

01-09-2020 | COVID-19 | Original Scientific Report

Impact of Personal Protective Equipment on Surgical Performance During the COVID-19 Pandemic

Authors: Carlos Yánez Benítez, Antonio Güemes, José Aranda, Marcelo Ribeiro, Pablo Ottolino, Salomone Di Saverio, Henrique Alexandrino, Luca Ponchietti, Juan L. Blas, Juan Pablo Ramos, Elena Rangelova, Mercedes Muñoz, Carlos Yánez Sr., International Cooperation Group on PPE and Emergency Surgery

Published in: World Journal of Surgery | Issue 9/2020

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Abstract

Background

The Severe Acute Respiratory Syndrome Coronavirus 2 pandemic has exposed surgeons to hazardous working conditions, imposing the need for personal protective equipment (PPE) use during surgery. The use of such equipment may affect their non-technical skills, augment fatigue, and affect performance. This study aimed to assess the surgeons’ perceptions of the impact of wearing PPE during emergency surgery throughout the pandemic.

Methods

An international cooperation group conducted an anonymous online survey among surgeons from over 30 countries, to assess perceptions about the impact of PPE use on non-technical skills, overall comfort, decision making, and surgical performance during emergency surgery on COVID-19 patients.

Results

Responses to the survey (134) were received from surgeons based on 26 countries. The vast majority (72%) were males. More than half of the respondents (54%) felt that their surgical performance was hampered with PPE. Visual impairment was reported by 63%, whereas 54% had communication impediments. Less than half (48%) felt protected with the use of PPE, and the same proportion perceived that the use of such equipment influenced their decision making. Decreased overall comfort was cited by 66%, and 82% experienced increased surgical fatigue.

Conclusions

Surgeons perceived impediment for both visibility and communication, and other non-technical skills while using PPE on emergency surgery in COVID-19 patients. Their perceived lack of protection and comfort and increased fatigue may have inhibited their optimal surgical performance. More attention should be placed in the design of more user-friendly equipment, given the possibility of a second wave of the pandemic.
Literature
1.
go back to reference Lu H, Stratton CW, Tang Y (2020) Outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. J Med Virol 92(4):401–402CrossRef Lu H, Stratton CW, Tang Y (2020) Outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. J Med Virol 92(4):401–402CrossRef
6.
go back to reference Zhang W, Du RH, Zheng XS et al (2020) Molecular and serological investigation of 2019- nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect 9(1):386–389CrossRef Zhang W, Du RH, Zheng XS et al (2020) Molecular and serological investigation of 2019- nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect 9(1):386–389CrossRef
8.
go back to reference Yule S, Paterson-Brown S (2012) Surgeons’ non-technical skills. Surg Clin North Am 92(1):37–50CrossRef Yule S, Paterson-Brown S (2012) Surgeons’ non-technical skills. Surg Clin North Am 92(1):37–50CrossRef
9.
go back to reference Hull L, Sevdalis N (2015) Advances in teaching and assessing nontechnical skills. Surg Clin North Am 95(4):869–884CrossRef Hull L, Sevdalis N (2015) Advances in teaching and assessing nontechnical skills. Surg Clin North Am 95(4):869–884CrossRef
12.
go back to reference Suen LKP, Guo YP, Tong DWK et al (2018) Self-contamination during doffing of personal protective equipment by healthcare workers to prevent Ebola transmission. Antimicrob Resist Infect Control 7:157CrossRef Suen LKP, Guo YP, Tong DWK et al (2018) Self-contamination during doffing of personal protective equipment by healthcare workers to prevent Ebola transmission. Antimicrob Resist Infect Control 7:157CrossRef
13.
go back to reference Tomas ME, Kundrapu S, Thota P et al (2015) Contamination of health care personnel during removal of personal protective equipment. JAMA Intern Med 175(12):1904–1910CrossRef Tomas ME, Kundrapu S, Thota P et al (2015) Contamination of health care personnel during removal of personal protective equipment. JAMA Intern Med 175(12):1904–1910CrossRef
14.
go back to reference Zellmer C, Van Hoof S, Safdar N (2015) Variation in health care worker removal of personal protective equipment. Am J Infect Control 43(7):750–751CrossRef Zellmer C, Van Hoof S, Safdar N (2015) Variation in health care worker removal of personal protective equipment. Am J Infect Control 43(7):750–751CrossRef
17.
go back to reference Sim SW, Moey KSP, Tan NC (2014) The use of face masks to prevent respiratory infection: a literature review in the context of the Health Belief Model. Singapore Med J 55:160–167CrossRef Sim SW, Moey KSP, Tan NC (2014) The use of face masks to prevent respiratory infection: a literature review in the context of the Health Belief Model. Singapore Med J 55:160–167CrossRef
18.
go back to reference Chughtai AA, Seale H, Dung TC et al (2016) Compliance with the use of medical and cloth masks among healthcare workers in Vietnam. Ann Occup Hyg 60:619–630CrossRef Chughtai AA, Seale H, Dung TC et al (2016) Compliance with the use of medical and cloth masks among healthcare workers in Vietnam. Ann Occup Hyg 60:619–630CrossRef
19.
go back to reference Satava R, Gallagher AG, Pellegrini CA (2003) Surgical competence and surgical proficiency: definitions, taxonomy, and metrics. J Am Coll Surg 196(6):933–937CrossRef Satava R, Gallagher AG, Pellegrini CA (2003) Surgical competence and surgical proficiency: definitions, taxonomy, and metrics. J Am Coll Surg 196(6):933–937CrossRef
21.
go back to reference Engelmann C, Ure B (2012) Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial. Surg Endosc 25(12):1245–1250 Engelmann C, Ure B (2012) Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial. Surg Endosc 25(12):1245–1250
Metadata
Title
Impact of Personal Protective Equipment on Surgical Performance During the COVID-19 Pandemic
Authors
Carlos Yánez Benítez
Antonio Güemes
José Aranda
Marcelo Ribeiro
Pablo Ottolino
Salomone Di Saverio
Henrique Alexandrino
Luca Ponchietti
Juan L. Blas
Juan Pablo Ramos
Elena Rangelova
Mercedes Muñoz
Carlos Yánez Sr.
International Cooperation Group on PPE and Emergency Surgery
Publication date
01-09-2020
Publisher
Springer International Publishing
Keywords
COVID-19
Fatigue
Published in
World Journal of Surgery / Issue 9/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05648-2

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