General surgery and COVID‑19: review of practical recommendations in the first pandemic phase



In March 2020, the World Health Organization confirmed COVID-19 infection as a pandemic. The absence of previous knowledge of the COVID-19 has made the decision-making difficult including in the surgical departments. The purpose of this report was to review the management recommendations regarding surgical activity and changes to surgical practice, identifying concordances and discrepancies.


A search of electronic datasets (PubMed Database, Google and Google Scholar) was conducted using the keywords ”SARS-CoV-2”, ”covid-19”, ”surgery”, ”recommendations”, ”guideline” and ”triage”. The search was limited to the first two months after the pandemic began and was closed on 6th May 2020.


Twenty papers were considered. The present recommendations concern: 1. General aspects such as the safety of health personnel and indications to surgery; 2. The preoperative phase with suggestions to activate different care pathways for COVID-19 positive patients; 3. The operative phase with the recommendation to activate safety measures in presence of aerosol generating procedures; 4. The postoperative phase with some management suggestions regarding operating theatres and patient transfers.


The recommendations analysed in the revised documents should be considered good practices aimed at increasing safety for patients and healthcare professionals. However, these recommendations must be contextualised in each individual hospital.

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