Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies

Nasser A N Alzerwi; Musaed Rayzah; Ahmad K Alnemare; Ahmed M E Elkhalifa

doi:10.3390/healthcare12010096

Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies

Healthcare (Basel). 2023 Dec 31;12(1):96. doi: 10.3390/healthcare12010096.

Authors

Nasser A N Alzerwi¹, Musaed Rayzah¹, Ahmad K Alnemare², Ahmed M E Elkhalifa^{3

4}

Affiliations

¹ Department of Surgery, College of Medicine, Majmaah University, Ministry of Education, Al-Majmaah City 11952, P.O. Box 66 Riyadh, Saudi Arabia.
² Otolaryngology Department, College of Medicine, Majmaah University, Ministry of Education, Al-Majmaah City 11952, P.O. Box 66 Riyadh, Saudi Arabia.
³ Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 11673, Saudi Arabia.
⁴ Department of Haematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti 1158, Sudan.

Abstract

Background: The coronavirus disease (COVID-19) pandemic significantly disrupted surgical care worldwide, affecting different specialties in various ways. Lockdowns, surges in COVID-19 cases, and changes in hospital policies notably impacted patient attendance, management practices, and access to surgical services. This scoping review examines the adverse impacts of the COVID-19 pandemic on surgical services and the policies adopted to address these care barriers.

Methods: We conducted a comprehensive literature review using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. Our search, spanning 31 December 2019, to 29 January 2023, focused on understanding the multifaceted impacts of COVID-19 on surgical services, particularly across different specialties.

Results: An analysis of 75 articles indicated that the pandemic challenged surgeons worldwide to maintain a balance between delivering emergency and elective surgical care, and implementing safety measures against viral transmission. There was a marked decline in the surgical volume, leading to extended waitlists and decreased operating theater usage. Strategies such as prioritizing medically necessary and time-sensitive surgeries and integrating telemedicine have emerged as pivotal for ensuring the continuity of urgent care. Despite the reduced rates, essential surgeries such as appendectomies and cancer-related operations continued, yet faced hurdles, including reduced staffing, limited operating theater capacity, and complications in patient transfers.

Conclusions: This review emphasizes the steep reduction in surgical service utilization at the beginning of the pandemic and emergence of new compounded barriers. Policies that designated surgeries as essential, and focused on equitable and timely access, were effective. Incorporating these findings into post-pandemic assessments and future planning is crucial to sustain adequate surgical care during similar health emergencies.

Keywords: hospital resources; pandemic; surgery; surgical services; systematic review.

Publication types

Review

Grants and funding

The authors would like to thank the Deanship of Scientific Research at Majmaah University for supporting this work under project number no. R-2023-895.