971 Impact Of COVID-19 Surgical Guidelines on Sternal Wound Infections During The COVID-19 Pandemic in A Large London Hospital: An Unexpected Benefit

Abstract

IntroductionSternal wound infections (SWI) are typically associated with a high morbidity and mortality. Rigorous peri-operative guidelines were instituted during the pandemic. The impact of these measures on SWI was investigated.MethodWe performed a retrospective analysis of all patients who underwent cardiac surgery at our institution since March 2020 post intervention (new COVID-19 peri-operative guidelines). A retrospective analysis of all patients who underwent cardiac surgery in the 12 months preceding the lockdown was also performed as a baseline cohort group.ResultsA total of 2,600 patients (493 during the COVID-19 pandemic) were included in this study. Urgent/emergency procedures accounted for more than 60% of procedures performed during the lockdown compared to 39% previously. 67 (2.6%) surgical wound infections occurred in the study population. During the COVID pandemic, there were 4 SWIs with an overall incidence rate of 0.8%. Patients who underwent cardiac surgery during the COVID pandemic had a lower than expected rate of surgical wound infections (P = 0.006). Other significant predictors of surgical wound infections included a diagnosis of diabetes and being a smoker.ConclusionsThis report suggests that a significant proportion of SWI’s are iatrogenic related and can be avoided through a rigorous attention to detail in the peri-operative setting.