The Operating Theatre journal April 2021

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Leading medical organisations publish new surgeryguidance for the one in five patients who have had COVIDGuide lets patients know when to wait for surgery, as studies suggest 10-fold increase in death for adults with an active COVID infectionNew standards will strive to make surgery as safe as possibleIn a new guide published recently in the journal Anaesthesia, a leading group of professional medical organisations are calling for the NHS to usenew standards to manage surgical patients who have previously had COVID. The guidance produced by the Centre for Perioperative Care, theRoyal College of Anaesthetists, the Royal College of Surgeons of England, the Association of Anaesthetists and the Federation of Surgical SpecialtyAssociations advises patients to wait or risk higher mortality rates.An estimated 15-20% of UK adults have contracted COVID during the pandemic. As the NHS begins to tackle the backlog of surgery, this guide willhelp inform the decisions of those patients who need an operation in the near to medium-term future.With some studies suggesting a 10-fold increase in death for adults having an operation1 around the time of getting an active COVID infection,compared with non-COVID patients. It is vital that this group of patients receives surgery that is as safe as possible and appropriate for them.The guidance is informed by academic studies and the latest data from the COVIDSurg group2.Key Guidance points:1. Emergency surgery, even for a patient without a PCR positive test should proceed with full COVID precautions.2. For elective or planned surgery, a delay of seven weeks after infection is recommended, including for people who are otherwise asymptomatic(but have had a positive test).3. There should be an individual assessment and longer preparation time for COVID patients who have recently been treated with steroids or whohave had on-going or previously severe COVID symptoms.4. Timing of surgery following a COVID infection should involve shared decision-making between the patient and their healthcare team – thisincludes discussions about the risks and benefits of operating, alternatives to surgery, and doing nothing. This is particularly important as thehealth of many patients may have deteriorated during the pandemic5. All patients should use the time before their surgery to better prepare for their procedure, e.g. by gradually improving their fitness or bystopping smoking, as this greatly reduces complications after operations, especially if they have other medical problems. It is important thatwe change the patient’s perception, so they see this period not as waiting time but preparation time.Mrs Scarlett McNally, Deputy Director of the Centre for Perioperative Care (CPOC) and Consultant Orthopaedic surgeon said:“This guidance is invaluable for the teams trying to plan care. One in ten patients with COVID will need specialised input and the guide is clear onwho this affects. For all patients, we need to move towards a modelwhere ‘waiting lists’ for surgery become ‘preparation lists’ – wherepatients use this time to get as fit as possible for their surgery.“Evidence shows that simple interventions such as a daily walk,practicing sit-to-stand exercises and having medication reviewed canreduce complications by between 30%-80%. Patients who have hadCOVID have been through enough – we now need to help empowerthem through shared-decision making and making best use of theirwaiting period to have the best possible outcome following theirsurgery.”Dr Kariem El-Boghdadly, Consultant Anaesthetist and lead clinician forthe guidance:“We have a growing number of patients that need surgical care and agrowing number of patients who have had COVID-19. What we wantedto do is ensure that these patients receive the safest surgical carepossible in the face of previous COVID-19 infection. We need to getthrough the NHS waiting lists as safely as we can and we hope this newguidance will help us achieve that for all our patients.”Download guidelines here:Patient Safety in Perioperative PracticeTuesday 20 April 2021#PSPP215 CPD creditsSARS-CoV infection, COVID-19 and timing of elective surgery.pdfLink to guidelines here: doi.org/10.1111/anae.15464Access a patient-facing resource here: www.cpoc.org.uk/patientsReference1. Delaying surgery for patients with a previous SARS-CoV-2 infection.British Journal of Surgery 2020; 107: e601–e602.2. CovidSurg was a platform of studies aiming to explore the impact ofCOVID-19 in surgical cases and services. It can be accessed here:https://globalsurg.org/covidsurg/Venue: OnlineRegistration: Member/Fellow £160, Anaesthetist in Training/MTI Doctor £120, SeniorFellows and Members Club £80, Non-members £215, Student £40Clinical Content Leads: Dr Haresh Mulchandani & Dr David SelwynA joint event with the Centre for Perioperative Care (CPOC), this one day meeting will discusspatient safety, including the barriers to delivering safe perioperative care and strategies on how toovercome them.Our aims are to build upon knowledge and practice to make systems, processes and organisationssafer. Through an understanding of the science of patient safety, different perspectives andapproaches, coupled with collaboration, education & quality improvement programmes we hopeto inspire delegates to make safety the golden thread of patient care.The RCoA will make a donation of £5 to Lifebox for every delegate attending this event.www.facebook.com/TheOTJ2 THE OPERATING THEATRE JOURNAL www.otjonline.com
THE THETHESEPTEMBER APRIL 2020 2021 2020 ISSUE NO. NO. 360 360 367 ISSN 0000-000X 1747-728XSEPTEMBER 2020 ISSUE NO. 360 ISSN 0000-000XThe The Operating Theatre Theatre JournalJournalOTJONLINE.COM £2.00OTJONLINE.COM£2.00The The Leading Leading Independent Print Print & Digital & Digital Journal Journal For For ALL ALL Operating Theatre Theatre StaffStaffThe Leading Independent Print & Digital Journal For ALL Operating Theatre StaffCS Medical is now Care SurgicalCS Medical have now completed our rebrand to Care Surgical. Over thepast 5 years CS Medical has become a trusted name in the operatingtheatre and is widely known for our outstanding product qualityand customer service. Our first positioning solution, the Prone PlusHelmet and Face cushion has now helped protect over a quarter of amillion prone patients worldwide. Although the CS name is well known andrespected among our many customers, we felt that it didn’t fully represent ourpurpose and company philosophy.So why Care Surgical?Simple, our mission is to advance and improve patient Care in the Surgical environment.Our commitment to enhance patient outcomes is our prime focus as well as the driving force behindeverything that we do. Correct positioning is essential for a positive surgical outcome and nowhere is thistruer than during prone procedures. From pressure related injury to nerve damage and even blindness pronepositioning poses a serious risk to the patient. For these reasons Care Surgical have not just developed singleproducts but full positioning solutions.Our latest innovation, the CS Spine Frame, provides a comprehensive tabletop solution for prone positioning.From the head to the arms, chest, hips, knee’s and feet we strive to ensure that the patient’s whole anatomyis correctly and safely supported. The system gives you a patient position comparable to that of a specialistspine table but at a fraction of the cost. In 2020 we partnered with Kyra Medical who’s innovative portfolioof patient positioning devices are a perfect compliment to the existing Care Surgical products.So what’s changed?We’re the same company with the same experienced team, just with a new face! We feel our fresh newbrand better represents who we are and our position as innovative product engineers and reliable suppliersof high quality, affordable positioning solutions. Visit our new website at www.care-surgical.comClinically-led changes result in savings of more than £450,000annually for NHS trustNHS Supply Chain has worked in partnership with ahospital trust to help them save more than £450,000annually after a change of supplier for hip and kneeproducts for orthopaedic surgery.City Hospitals Sunderland NHS Foundation Trust andSouth Tyneside NHS Foundation Trust who merged in2019 decided to undertake the orthopaedic projecttogether with support from NHS Supply Chain categorymanager and clinical engagement and implementationmanager.This enabled them to move to one orthopaedic providerfor their hips and knees as soon as they had mergedto achieve the best value for the products across bothsites. Orthopaedic clinicians led the decision on thenew hip and knee providers.As a result, South Tyneside and Sunderland NHSFoundation Trust saved £458,060 against a previousannual spend of £1,509,396 - a saving of 30 percent.They achieved the savings by going from sevendifferent suppliers to one and rationalising the productrange for surgeons.A trust spokesman said: “We worked closely with NHSSupply Chain and the suppliers on this orthopaedicproject, to evaluate and rationalise the productrange. Their expertise relating to the pricing exerciseenabled the timescales to be reduced and the savingswere realised earlier than anticipated.”Emmi Mitrunen, a Category Manager specialising inorthopaedics at NHS Supply Chain, said: “It was veryimportant that the product alternatives were clinicallyacceptable across both hospital sites.We offered access to a breadth of products andthe ability to continue close working relationshipswith suppliers whilst remaining compliant.”The trust was supported through the project byEmmi and Ben Harrington, a Clinical Engagementand Implementation Manager who has specialistknowledge of orthopaedic products and abackground in orthopaedics theatres.“We supported the orthopaedic project byworking with the clinical teams to understandwhich suppliers they would be willing to consideras alternatives to their current hip and kneeproviders,” said Emmi.The clinicians agreed to look at five differentsuppliers, who were all invited to present theirproducts at a supplier day. As a result, twosuppliers were identified as being able to supplya full range of hips and knees across both sites.Each supplier’s products were trialled at bothsites, with one supplier taking part at a time. Thisenabled all clinicians to participate in the trials.NHS Supply Chain was able to deliver products,expertise and pricing available under the TotalOrthopaedic Solutions framework.The standardised compliant process was managedfrom beginning to end by NHS Supply Chain onbehalf of the trust, including providing productanalysis, organising meetings and supplier days,providing contract documentation and ensuringeveryone involved was kept up-to-date withdevelopments.Inside this issueOver 100 UK medicalprofessionals registered for thefree COVID-19 coursesP4NHS contact centre wins Goldaward at prestigious EuropeanawardsP4BAOMS President welcomesRCSEng independent reviewP4Sustainable and fit-for-purposeOMFS training, BAOMS PresidentpledgesP6The Infection PreventionSociety is pleased to promoteeducational covid-19 videoP10Sheffield researchersto lead major studyP10RCoA Consultation intoregulation of AnaesthesiaAssociatesP12Pioneering £1.8m study toinvestigate if pregnancy successrates improved by removingsmall fibroidsin wombP16From bomb disposal topioneering healthcare roleP18The South West CancerAlliance’s moves towardseradication of “TRUS” ProstateCancer Biopsy.P19Assuring Sterility in SurgicalInstruments ReprocessingP21How can Civility in the OperatingTheatre be Improved to EnhancePatient Safety? (Part 1)P22Sheffield Teaching Hospitalsconsultant elected as Presidentof prestigious national societyP24FDA is Investigating Reportsof Infections Associated withReprocessed UrologicalEndoscopesP26Why Men must researchtheirProstate Cancer treatmentoptions.P29Augmented reality could changethe way we carry out minimallyinvasive surgeryP29Find out more 02921 680068 • e-mail admin@lawrand.com Issue 367 April 2021 3
Page 1: THE THETHESEPTEMBER APRIL 2020 2021
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Page 8 and 9: A £1.7M refurbishment of theatres
Page 10 and 11: Sheffield researchers to lead major
Page 12 and 13: Bender UK expands with new business
Page 14 and 15: Major Multi-Disciplinary Spine Conf
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Page 18 and 19: From bomb disposal to pioneering he
Page 20 and 21: Assuring Sterility in Surgical Inst
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Page 24 and 25: First Total ShoulderArthroplasty Us
Page 26 and 27: FDA is Investigating Reports of Inf
Page 28 and 29: WINNERS ANNOUNCED: Medical Robotics
Page 30: Your firstchoice inanaesthesiaA ran

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