Abstract
The spread of the COVID-19 disease substantially influenced the International Healthcare system, and the national governments worldwide had before long to decide how to manage the available resources, giving priority to the treatment of the COVID-infected patients. Then, in many countries, it was decided to limit the elective procedures to surgical oncology and emergency procedures. In fact, most of the routine, middle-low complexity surgical interventions were reduced, and the day surgery (DS) activities were almost totally interrupted. As a result of this approach, the waiting list of these patients has significantly increased. In the current phase, with a significant decrease in the incidence of COVID-19 cases, the surgical daily activity can be safely and effectively restarted. Adjustments are mandatory to resume the DS activity. The whole separation of pathways with respect to the long-stay and emergency surgery, an accurate preoperative protocol of patient management, with a proper selection and screening of all-day cases, careful scheduling of surgical organization in the operating room, and planning of the postoperative pathway are the goals for a feasible, safe, and effective resumption of DS activity.
Highlights
COVID-19 pandemic is incontestably one of the greatest events with social and public health impact ever recorded in the history of humanity
The state of alert, remains very high. It is an unmatched medical emergency, being able to induce a sudden change in management of available healthcare resources for elective surgery, to reallocate funding to the COVID-19 patient’s care
If the disease does not allow a delay of care, patients must be sent to a common COVID pathway, as well as emergency and long-stay patients, not able to set back the surgical interventions
Summary
COVID-19 pandemic is incontestably one of the greatest events with social and public health impact ever recorded in the history of humanity. Recommendations for outpatient activity in COVID-19 pandemic 1697 recorded a complete cessation of intervention, and the dedicated operating rooms are no longer used For this reason, these surgical models need to get valid, standardized recommendations to restart as quickly as possible [3]. DS is commonly performed in free-standing units or dedicated hospital areas, with separated access to spaces for admission, and operating rooms exclusively reserved for daycare activities, with separate pathways regarding the emergency and long-stay units This allows safer and more appropriate activities and processes management. If the disease does not allow a delay of care, patients must be sent to a common COVID pathway, as well as emergency and long-stay patients, not able to set back the surgical interventions. The implementation of protocols and recommendations can allow an early restart of DS procedures, remaining ready to stay active in the unfortunate event of a possible further wave of the epidemic
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