COVID-19 could result in killing quantities of people and resources have been appropriately allocated towards combating this outbreak and the current situation of prevention and control is severe. All of the involved health care personnel were rapidly trained to use personal protection equipment. Critical patients often occur in the elder with multiple comorbidities or lack of health care, which could progress to acute respiratory distress syndrome (ARDS), multi-organ dysfunction (MODS), or even death [10, 11]. Furthermore, besides clinical activities, continuously important research projects were carried out to explore new strategies and effective therapies to face the epidemic.
The epidemic of COVID-19 poses new challenges to diagnosis and treatment of the patients with orthopedic diseases [12]. We medical workers bearing important responsibilities and pressure through strict management strategy during the epidemic. Orthopedic surgeons performed the superiority of accurate diagnosis and treatment for patients, summarized how to carry out the clinical practice of orthopedic surgery under the situation of the prevention and control of the COVID-19, and minimized the risk of infection exposure.
It is particularly important to underline the clinical features of COVID-19, especially in the early stage of the illness. Up to now, multiple guidelines have been issued by various organizations to recommend their practice. In relationship with orthopedic diseases during the epidemic, related prevention and control, clinical recommendations, diagnosis and treatment, clinical management, healthcare personnel protection and disinfection were applied soon in our hospital.
Responses to national recommendations, local infection control guidelines and tailored to the availability of medical resources are imminently adopted to against the pandemic [13, 14]. Laura et believe that anti-inflammatory drugs (NSAIDs) may induce increased sensitivity to more severe clinical features in coronavirus infection [15]. The Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology shared their experience [16]. Luo introduced details of Renji experience as for parts of general surgery [17]. Italian urologists recommended on pathways of perioperative care for urological patients undergoing urgent procedures, which may be inspired for urological societies [18]. Anesthesiologists are required to adopt tailor anesthetic practices to individual patients will ensure the best outcomes [19]. Former researchers provide the views of related diseases and they believed that strategies were suitable for physicians, which is good for both patients and the perioperative management team.
Based on the fully understanding of the characteristics of orthopedics diseases and COVID-19, In order to summarize and discuss available evidence for orthopedic practices, we provide the highest quality medical services in the form of flow charts as for the regular clinical practice.
The healthcare personnel of department of orthopedics are vulnerable to the infection due to their extensive and close exposure to patients. In consideration of the rapid spread of epidemic, health care staff are at added risk of exposure and infection during the practice of treatment [20]. To reduce the number of people in the hospital, physio-therapy should be provided only to immediate postoperative patients [21]. The treatment strategy should be changed timely and appropriate methods should be adopted to minimize the adverse effect of the epidemic in orthopedics diseases’ treatment.
It is still a difficult task how to maximize the protection for health of medical staff, and the safety of wards and hospitals. In our study, no one of medical staff was infected during the clinical practice. Preserving a highly skilled health care workforce is a top priority for any community and health care system. To avoid the aggravation of COVID-19 or collapse of the health system, emergency department was emphasized in our hospital and several recommendations were issued to help support healthcare workers against the pandemic.
There are several limitations in our study. First, we conducted this retrospective cohort study by using a database in our department within two years, particularly with new generation constructs. Prospective studies are needed to validate these calculators and refine over time. Moreover, the database was small and did not include information on long-term follow-up outcomes. Last but not least, the provided flow charts, which may evolve over time, could be used as guidance for health care workers who are involved in the care of patients. When available, we will provide new evidence in further releases of these guidelines and we believe that future studies are necessary to define more flow charts briefly and clearly.