• Andreas A Schnitzbauer, Kempf Volkhard A J VAJ Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum Frankfurt, Goethe-Universität Frankfurt am Main, Theodor-Stern, Daniel Hack, Sandra Ciesek, Simon Meier, Vehreschild Maria J G T MJGT University Center for Infectious Diseases, University Hospital Frankfurt, Universitätsklinikum Frankfurt, Goethe-Universität Frankfurt am Mai, Sabine Wicker, Ulf Kippke, Jürgen Graf, and Ingo Marzi.
• Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Frankfurt, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. andreas.schnitzbauer@kgu.de.
• Chirurg. 2020 Jul 1; 91 (7): 576-585.

BackgroundThe SARS-CoV-2/COVID-19 pandemic necessitates a rapid reorganization of the hospital procedures. The establishment of centers dedicated to COVID-19 treatment and care also necessitates preparation of the surgical departments for the forthcoming emergency interventions for infected patients and patients with an unclear infection status. This article summarizes the evidence on standards for personal protective equipment for personnel in the central emergency admission department and in the operations area as well as restructuring measures for the procedures in the operations area in a COVID-plus area.MethodA systematic literature search was carried out.ResultsThe grey area of unknown infected and potential transmitters of SARS-CoV-2/COVID-19 is high. Patients with an unclear infection status or who are highly suspected of having an infection should be classified as infectious until the contrary can be proven. The protection of personnel in healthcare professions against infections is of particular importance. The supply of adequate personal protective equipment in a risk-stratified form can substantially influence the success of combating the pandemic. Most operations must be assessed as aerosol-forming procedures and necessitate the maximum protection of personnel working directly on the patient. Particular attention should be paid to obligatory hygiene regulatory measures for protection against contamination during the reorganization in the operations area and on the transport routes between the wards.ConclusionThe correct personal protective equipment considering the occupational safety helps to sustainably protect personnel from infections. Reorganizational measures in the operating room are urgently indicated for potential aerosol-forming procedures in infected patients or patients with an unclear infection status. The current dynamic situation necessitates a high level of flexibility as well as reassessment and adaptation of the measures at short intervals.

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