Orthopaedic operating room considerations in covid-19 pandemic: A systematic review

PURPOSE: Worldwide COVID 19 has affected the medical practices and Orthopaedics is not any different. Despite risk, the surgeons cannot deny the surgical procedure on patients with suspected or confirmed COVID 19 infection. The purpose of this manuscript is to review various operating room measures which are recommended and being followed to carry out orthopaedic surgeries in the current scenario of COVID 19 pandemic. The information would be useful for orthopaedic surgeons to carry out safe surgical practice for reducing the transmission of COVID 19 infection. METHOD: ology: A systematic literature search was performed using search engines- PubMed, Google Scholar and Scopus from January to August 2020 for relevant research articles. The keywords utilized for systematic literature search were “COVID 19”, “Corona virus” and “Operating room”, “Orthopaedic procedure” in 4 combinations. Duplicates were excluded. Further sorting was done according to the pre-set inclusion and exclusion criteria. Original articles pertaining to orthopaedic surgery and operating room in COVID 19 and available in English language were included. Editorials, case reports, other speciality articles were excluded. RESULTS: 16 articles were finally included in review after screening for titles, abstracts and full texts. The information obtained is presented as a narrative review. CONCLUSION: Various important recommendations include use of negative pressure OR, HEPA filters, dedicated separate OR for COVID positive and suspected patients with well defined separate corridors for transport, avoid AGP wherever possible, minimize the number of assistants and staff and follow strict sanitation protocols after each surgery. A well planned systematic approach is warranted to mitigate the risk of transmission of COVID 19 while carrying out orthopaedic surgeries.