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Elective surgery came to a halt during the first wave of COVID-19. The safe resumption of elective surgery with COVID-19 prevalent in the community, remains a significant challenge. The aim of this study was to look into the outcomes of elective general surgery in a dedicated ‘Green Zone’ following the first wave of COVID-19. Methods A ‘Green Zone’ pathway was drafted which was meant to provide a COVID-free environment for patients. Prospective data was collected on consecutive patients who underwent elective general surgical procedure at a single NHS trust over a 10-week period (1st Sept 2020 - 10th Nov 2020). The primary outcome was 30-day COVID-19 mortality. Secondary outcomes included 30-day nonCOVID-19 mortality, readmissions and complications. Results The study included 185 patients with a median age 55 years (IQR 41-67); 96 (52%) were females. Majority of the patients were ASA 2 (n = 98, 53%) followed by equal number of ASA 1 and ASA 3 (n = 42, 23%). 33 patients (18%) had been shielding earlier in the year. 96% underwent general anaesthetic. Most of the cases were day cases (n = 131, 71%). There was no 30-day COVID-19 or nonCOVID-19 mortality. One patient developed COVID-19 three weeks after the index operation. 30-day readmission and complication rate were 5% (n = 10) and 10% (n = 18). Most of the complications were Clavien-Dindo grade 1(n = 8, 4%) and 2(n = 8, 4%). Conclusion This study has shown that dedicated ‘Green Zone’ elective operating pathway is safe provided a balanced risk assessment approach is adopted.

SP4.2.4 Single centre experience of ‘Green Zone’ elective general surgery after the first wave of COVID-19