Pre-Surgery Isolation Is Leading To Worse Patient Outcomes

COVID precautions are presenting new reasons for concern in surgeries. 

Perhaps one of the most lingering side effects of the pandemic has been the effect it’s had on mental health. It’s no secret that stress, fear and isolation from friends and family has had an impact. And according to research, the effects of poor mental health are leading to higher chances of complication in surgical outcomes. 

A new study has revealed that patients who isolate before surgery as a COVID-19 precaution actually have a higher risk of lung complications after their operation than those who don’t isolate. The study was done by the University of Birmingham-led GlobalSurg-COVIDSurg Collaborative, a global partnership of more than 15,000 surgeons who are gathering a range of data on the COVID-19 pandemic.

Study results are eye-opening

The study analysed data from more than 96,000 patients in 114 countries, including nearly 27,000 who isolated before surgery. After adjusting for age, other health problems and type of surgery, researchers concluded that patients who isolated before surgery had a 20% higher risk of lung complications after their operation than those who didn’t isolate.

And the risk rose if patients isolated for more than three days. Isolation of four to seven days was associated with a 25% increased risk. And isolation of eight days or longer with a 31% increased risk.

According to study co-leader Dr. Aneel Bhangu of the university’s National Institute for Health Research Global Health Research Unit on Global Surgery, “Isolation may mean that patients reduce their physical activity, have worse nutritional habits and suffer higher levels of anxiety and depression,” he said in a journal news release. “These effects in already vulnerable patients may have contributed to an increased risk of pulmonary complications.”

A local perspective

Dr Jack Zoumaras is a Specialist Plastic Surgeon and founder of Sydney’s Artiste Plastic Surgery. He and his team at Artiste have been able to operate throughout recent lockdowns. Patient safety has remained a priority as the COVID environment continues to change. It’s lead to mandatory isolation pre and post-surgery for his patients. 

Dr Jack Zoumaras

“Our current protocol in Sydney is for patients to obtain a negative COVID-19 test 72 hours before surgery and to isolate until the surgery. After surgery, patients recover at home and in isolation, which is normal even pre-COVID. We’ve been doing this since the first week of July and hospitals are now mandating this from the LGA in question thus far. 

“We do it for all patients. This ensures that the patient and staff at the hospital are as protected as possible. Over 70% of hospital staff and all of Artiste is immunised so the use of negative COVID-19 tests and isolation ensures appropriate care and protection.”

Dr Zoumaras acknowledges that isolation can have a lasting impact on patients, particularly on top of the stress of going into surgery. 

“Having plastic surgery is daunting at the best of times and psychologically lonely. I discuss this topic more in an upcoming book I am writing on the psychology of having plastic surgery. Having to isolate pre-surgery and with the media coverage of the Delta strain in Sydney adds another element of stress. Patients are still excited but it is a real mixed emotion.”

A fresh approach is needed

With these added impacts to factor in, the Artiste team have new procedures in place to help mitigate feelings of fear, stress and isolation in their patients.

“We offer more support during this time through video calls, constant phone calls and communication to ensure a smooth operative journey. When presenting for surgery the isolation continues as only the patient and not carer or transport person can come into the hospital. What we try to do at Artiste is run on time as much as possible because once the patient sees our familiar face in hospital they feel more at ease,” share Dr Zoumaras.

Isolating pre and post-surgery is a necessary part of plastic surgery right now, but there is still valuable advice to share with patients in order to reduce risks, according to Dr Zoumaras.

“It is an ever-changing landscape and constant clear communication is key. We recommend meditation, drinking lots of water and a vegetarian or vegan diet leading up to surgery to optimise your mental and physical health.”


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