Applying augmented reality to treat Fournier's gangrene in COVID-19 positive patients whilst safeguarding the multi-disciplinary surgical team: A case series.

Introduction: COVID-19 has presented the surgical community with a multitude of challenges. Patients requiring surgical intervention who are positive for COVID-19 are not only more likely to develop complications post-operatively, but also pose an increased infection risk to the surgical team involved in their care. The infection control concerns raised at the peak of the pandemic persist in the post-pandemic era as patients continue to test positive for COVID-19 and the risk of a 'second wave' looms.

Methods: We present a case series (compliant with SCARE [4] and PROCESS [5] criteria) to demonstrate the effective use of an AR technology platform during the intraoperative treatment of two complex COVID positive patients diagnosed with Fournier's gangrene.Retrospective review of prospectively collected data of all patients that required surgery involving multiple specialties during the COVID-19 pandemic at Jaber AlAhmad hospital in Kuwait between March 2020 to October 2020.

Presentation of case: We present two cases to highlight the use of an augmented reality (AR) platform during the treatment of COVID-19 positive patients with Fournier's gangrene in order to safeguard surgical teams whilst simultaneously enabling these complex cases to benefit from multi-specialty input intraoperatively.

Outcome: Augmented reality is a feasible option to minimize surgeons' exposure during surgery without compromising the patients safety.

Discussion: This case series demonstrates how AR solutions can be employed to bolster infection control measures and may be useful in the treatment of surgical patients who test positive for COVID-19.

Conclusion: AR solutions could be considered as an infection control strategy to safeguard surgical teams operating on COVID-19 positive patients.