We performed surgical procedures in two different surgical units, on two different floors. Patients with negative swab, normal chest radiograph, and absence of fever, cough, or history of contact were treated in a clean surgical unit, according to usual pre-operative, intra-operative, and post-operative procedures. COVID-19, suspected COVID-19, and patients without swab results, who needed rapid access to the OR, were operated on in a specific surgical unit. The unit was divided into three areas. The operating theatre was defined as contaminated area, or “red zone,” in the presence of an infected patient. The corridor between the ward and the OR, including recovery area, was considered partially contaminated area, or “gray zone.” The space including locker rooms, storage areas, relax zone, computer, and surgical report facilities was uncontaminated, or “white zone.” The patient, coming from the ward, wearing a surgical mask, was brought directly into the operatory room, passing through a gray zone, without any stop in recovery areas. All anaesthesiologic, surgical, and radiological procedures on the patient were performed inside the OR. At the end of the procedures, the patient left the theatre, and through the “gray zone” was brought directly to the ward (Fig. 3).
Fig. 3 Surgical unit divided into red zone (red mesh), gray zone (gray mesh), and white zone. Pathways for healthcare professionals (blue) and patients (red)