Abstract
AIMS: To assess if a “clean ward” model is effective in preventing peri-operative COVID-19 infection in elective general surgical patients. METHODS: Elective general surgical cases were audited prospectively in three thirty-day cycles - May–July 2020, September–October 2020 and December 2020–January 2021. Patients isolated for 10 days and required a negative COVID swab prior to admission. Nursing and surgical staff underwent weekly swabbing, operations were carried out in a dedicated “clean theatre” and a no-visiting policy was enforced. Inpatient COVID cases and COVID-19 status at 14 days post discharge were recorded and compared to the community COVID-19 Reproduction (R) number. RESULTS: Cycle 1, (May-Jul 20, R number=0.3-1.5) 44 elective patients. One patient was diagnosed with clinical COVID post-operatively and recovered well. Cycle 2, (Sept-Oct 20, R number=0.8-1.8) 57 patients identified. No positive COVID-19 cases during inpatient admission or at 14 days post discharge. Cycle 3, (Dec 20-Jan 21, R number=1.0-1.9) 38 elective patients. One patient tested positive for COVID-19 following transfer to the emergency surgical ward due to COVID-19 related bed pressures. No other positive cases were identified during follow up. CONCLUSIONS: Despite an ongoing rise in community COVID-19 cases, the “clean ward” model appears to be effective in reducing COVID-19 transmission for elective general surgical patients. When the R number was at its highest, the only COVID positive case developed symptoms after moving from the “clean ward” system. Extrapolation of this model could be considered in re-establishing elective operating lists across the region.