Clinical Data Analysis of 10,152 Patients Treated with Acupuncture during Perioperative Period

<p dir="ltr">Background</p><p dir="ltr">India has one of the world's highest burdens of antimicrobial resistance (AMR), largely driven by inappropriate antibiotic use. In surgical and orthopedic departments, broad-spectrum antibiotics are routinely used for perioperative antibiotic prophylaxis (PAP) and infection treatment, further contributing to AMR. Although surgical site infections (SSIs) pose a significant risk in surgical and orthopedic departments, there is a lack of surveillance systems and long-term studies on antibiotic prescribing practices and the factors influencing antibiotic use in Central India.</p><p dir="ltr">Aim <br><br>To increase knowledge about antibiotic prescribing practices, SSIs, and perceptions of AMR in surgical and orthopedic departments in Central India.</p><p dir="ltr"><br>Methods<br><br></p><p dir="ltr">Research was conducted in the orthopedic and surgical departments of three private-sector hospitals in the Ujjain district, Madhya Pradesh. Studies I-III are cross-sectional, involving prospective data collection, while Study IV is a qualitative study based on the integrated Capability, Opportunity, Motivation- Behavior model and the Theoretical Domains Framework. In Studies I and III, data were collected from the orthopedic (Study I) and surgical departments (Study III) of the teaching hospital (TH) and the non-teaching hospital (NTH-1) between 2008 and 2017. Antibiotic prescribing patterns were analyzed at the group level based on diagnoses. Total antibiotic use was measured in Defined Daily Doses (DDDs) per 1000 patient-days. Additionally, in Study III, antibiotics were categorized by Access Watch Reserve classification. Time trends in antibiotic use were analyzed using linear regression (Studies I and III) and polynomial regression (Study III). In Study II, data were collected from 2013 to 2016 in the orthopedic department of the TH. SSIs were identified based on the Centers for Disease Control and Prevention National Healthcare Safety Network criteria. Pathogens causing SSIs were identified according to Clinical and Laboratory Standards Institute guidelines. The American Society for Anesthesiologists classification system was used to assess patients' operative risk. Risk factors for orthopedic SSI development were analyzed using univariable and multivariable backward stepwise logistic regression. In Study IV, semi-structured interviews were conducted in 2023 with 15 general and orthopedic surgeons at the TH, the NTH-1, and the NTH-2. The questions were designed to explore factors influencing antibiotic prescribing decisions, as well as surgeons' perceptions of antibiotic use, AMR, and potential solutions. Manifest and latent content analysis was applied.</p><p dir="ltr">Results</p><p dir="ltr">Antibiotic prescribing was rarely guided by culture and susceptibility testing, and no context-specific antibiotic prescribing guidelines were in place. In orthopedic departments, third-generation cephalosporins were the most used antibiotics, with fractures of the spine and limbs being the most prevalent indications. In surgical departments, fluoroquinolones and third-generation cephalosporins were the most commonly prescribed antibiotics, with inguinal hernia and calculus of kidney and ureter being the most common diagnoses. In orthopedic departments, total antibiotic use significantly increased over a 10-year period, whereas in surgical departments, it slightly decreased in the last three years (NTH-1) to five years (TH). Additionally, the proportion of prescribed Watch antibiotics significantly increased in surgical departments over the same period. Over a three-year period, the incidence of orthopedic SSIs was 7.6%. Risk factors for orthopedic SSI development included male sex (OR = 2.64, 95% CI 1.32-5.30), previous hospitalization (OR = 2.15, 95% CI 1.25-3.69), antibiotic use during hospitalization before PAP (OR = 4.19, 95% CI 2.51-7.00), postoperative length of stay longer than 15 days (OR = 3.30, 95% CI 1.83-5.95), and preoperative showering (OR = 4.73, 95% CI 2.72-8.22). The most used PAP in orthopedic surgery was a combination of a third-generation cephalosporin and a B-lactamase inhibitor with amikacin. The most common pathogen causing orthopedic SSIs was Staphylococcus aureus, which exhibited 100% resistance to penicillinase-labile penicillins. Various factors were found to influence the decision-making process for antibiotic prescribing among general and orthopedic surgeons, including environmental factors (e.g., dry and dusty rural setting); sociocultural factors (e.g., patients' socioeconomic status and beliefs); and the prescriber's experience, personal preferences, and seniority level. General and orthopedic surgeons largely perceived AMR as a social problem that requires a collective effort.</p><p dir="ltr">Conclusion</p><p dir="ltr">In orthopedic departments, total antibiotic use significantly increased over 10 years, whereas in surgical departments, it slightly decreased over the last three to five years of the same period. Antibiotic prescribing was predominantly empirical and strongly influenced by environmental and sociocultural factors. A considerable proportion of patients in orthopedic and surgical departments received antibiotics without clear indications, and PAP selection deviated from internationally recommended standards. The incidence of orthopedic SSIs was 7.6% over three years, which is relatively high for orthopedic surgeries but low compared to reported SSI incidences in India. Preoperative showering was identified as a significant risk factor for orthopedic SSIs, a finding not previously reported in the literature. This research emphasized the need to develop hospital antimicrobial stewardship programs, strengthen infection prevention and control measures and diagnostic practices, develop and implement context-specific antibiotic prescribing guidelines, and foster regular interdisciplinary collaboration. AMR was recognized as a complex social issue that requires a collective, multisectoral effort.</p><h3>List of scientific papers</h3><p dir="ltr">I. <b>Skender K,</b> Singh V, Stålsby Lundborg C, Sharma M. Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10- year observational study. PLoS ONE. 2021 Jan 27;16(1):e0245902. <a href="https://doi.org/10.1371/journal.pone.0245902" rel="noreferrer" target="_blank">https://doi.org/10.1371/journal.pone.0245902</a></p><p dir="ltr">II. <b>Skender K,</b> Machowska A, Singh V, Goel V, Marothi Y, Stålsby Lundborg C, Sharma M. Antibiotic Use, Incidence and Risk Factors for Orthopedic Surgical Site Infections in a Teaching Hospital in Madhya Pradesh, India. Antibiotics. 2022 May 31;11(6):748. <a href="https://doi.org/10.3390/antibiotics11060748" rel="noreferrer" target="_blank">https://doi.org/10.3390/antibiotics11060748</a></p><p dir="ltr">III. <b>Skender K,</b> Machowska A, Dhakaita SK, Stålsby Lundborg C, Sharma M. Ten-year trends of antibiotic prescribing in surgery departments of two private sector hospitals in Central India: a prospective observational study. BMC Public Health. 2024 Jan 27;24(1):310. <a href="https://doi.org/10.1186/s12889-024-17817-2" rel="noreferrer" target="_blank">https://doi.org/10.1186/s12889-024-17817-2</a></p><p dir="ltr">IV. <b>Skender K,</b> Machowska A, Khare S, Singh V, Stålsby Lundborg C, Sharma M. "Our hands are tied": A qualitative exploration of antibiotic prescribing practices and perceptions of antimicrobial resistance among general and orthopedic surgeons in Central India. [Submitted]</p>

Background and Aims:Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. There are limited observational prescription pattern studies of analgesics in perioperative period in tertiary care hospitals for which this study was carried out in orthopedic, general surgery, and plastic surgery departments. The primary aim was to study the prescription pattern of analgesics in the perioperative period with the secondary aim to study the specific use of opioids and pain relief using the Visual Analog Scale (VAS).Methods:A total of 250, 250, and 100 patients were taken from orthopedic, general surgery, and plastic surgery departments, respectively. The analgesics commonly used in preoperative, intraoperative, and postoperative period were observed. The use of opioids in the perioperative period, the number of fixed drug combinations used, the number of generic drug prescription, and pain relief postoperatively were also observed. The analysis was done using descriptive statistics.Results:Total analgesics prescribed were 1168, 117, and 369 in orthopedic, general surgery, and plastic surgery departments, respectively, and were maximum in the intraoperative period. Most commonly used analgesic in the preoperative and postoperative period was paracetamol and that in intraoperative period was fentanyl. Nonsteroidal anti-inflammatory drugs (NSAIDs) were mainly prescribed by the general surgery department in postoperative period. The amount of pain in postoperative period after treatment with analgesics was mild to moderate as per the VAS.Conclusion:This study revealed that in preoperative and postoperative period, the most common analgesic used is paracetamol. In the intraoperative period, maximum patients received fentanyl. Diclofenac is an established NSAID used in the management of acute and chronic pain states. In our study, we found that the usage of paracetamol was more than NSAIDs and the usage of opioid was maximum during intraoperative period.

Objective To survey the usage of prophylactic antimicrobial agents for the patients in type Ⅰ incision operation and provide reference for rational use of antibiotics clinically. Methods 456 surgical ca-ses of type Ⅰ incision operation were selected among the surgical patients discharged from department of gen-eral surgery, department of orthopaedics, department of neurosurgery, department of chest surgery, depart-ment of ophthalmology, department of stomatology, department of urology and department of otology from 2007 to 2008,excluding the cases of remedial antimicrobial agents before the operation. 331 cases used prophylac-tic antimicrobial agents were analyzed. Results There are problems in prophylactic antimicrobial usage in patients with type Ⅰ incision operation in this hospital, including antimicrobial agents not chosen properly, the indications not stringent, the timing of usage not appropriate. These problems can induce medical costs to go up and drug-resistance bacteria to increase. Conclusions Clinicians should learn the guiding principles for clinical application of antibacterial agent according to the features of different surgical departments, take essen-tial administrative actions for surveillance, and promote rational use of antibiotics in infection prevention of surgical intervention. Key words: type Ⅰ incision; antimicrobial agent; prophylactic usage

Objective To explore the cognition of nurses in high-risk surgical departments for prevention of venous thromboembolism (VTE) . Methods Totally 464 nurses in surgical departments at high risk of VTE (departments of orthopedics, general surgery, neurosurgery, thoracic surgery, and critical care medicine) from 11 provinces (municipalities and autonomous regions) nationwide who attended the seminar on nursing by the Chinese Nursing Association in September 2017 were investigated with VTE Prevention Knowledge Questionnaire for Clinical Nurses to understand their knowledge about basic, physical and drug prevention for VTE. Results The cognition of VTE prevention of nurses in high-risk surgical departments scored (13.51±3.42) , standing at a medium level. In particular, the knowledge about physical prevention was unsatisfactory, which scored (5.71±2.18) . The cognition score of VTE prevention varied in nurses of different departments, and the cognition of VTE prevention of nurses from departments of general surgery, orthopedics and critical care medicine was relatively better. Multivariate analysis revealed that educational background was an independent risk factor for the cognition of VTE prevention of nurses in high-risk surgical departments (OR=1.630, 95%CI: 1.035-2.567) . Conclusions The cognition of VTE prevention of nurses in high-risk surgical departments is unsatisfactory and cannot meet the needs of clinical work. Targeted training should be provided according to the weak links in the cognition of VTE prevention of nurses in high-risk surgical departments to improve the quality of VTE prevention and nursing, thus reducing the incidence rate of perioperative VTE in these patients. Key words: Venous thromboembolism; Prevention; Cognition; Surgical nurses; Investigation

Results The total number of isolated strains was 413, 231 in 2012 and 182 in 2013. In the intensive care units 151 nosocomial infections were identified; 88 strains in the Surgical Department, 27 strains in the Department of Gynecology and Obstetrics, 24 strains in the Department of Neurosurgery and 23 in the Orthopedic Department. 19 strains were identified in the Neurology Department and also in the Internal Medicine Department, 17 strains were identified in the Urology Department, 14 in the Aesthetic Surgery Department, 8 in the Nephrology Department, 8 in the Hematology Department and 5 in the Gastroenterology Department. 3 strains were isolated in each of the following departments: Diabetes and Nutrition Diseases, E.N.T and Neonatology and 1 strain was identified in the Cardiology Department. In terms of etiology, the most commonly isolated were: Enterobacter spp. (111) followed by Acinetobacter spp. (71), Escherichia coli (59), Staphylococcus aureus (46), Klebsiella spp. (30), Enterococcus spp. (20), Pseudomonas spp. (19), Proteus spp. (19), fungi (17), coagulase-negative Staphylococcus (11), Burkholderia cepacia (8), Serratia marcescens (5).

The aim of this study was to determine the amount of non-opioid analgesics consumed at the surgical departments of a secondary care hospital in Serbia, a developing country undergoing a socioeconomic transition that thus lacks sufficient funds to finance and invest in the healthcare system. At the departments of gynaecology, urology, otolaryngology, general surgery and orthopaedics with traumatology at the General Hospital, Kraljevo from 2010 to 2012, six different non-opioid analgesics were used: diclofenac, ketorolac, ibuprofen, metamizole sodium, paracetamol (for per os and parenteral use), and meloxicam (for parenteral use only). Drugs in the M01 Anatomical Therapeutic Chemical classification group were consumed statistically significantly more than drugs in the N02 group (U=0.000; p<0.001). With regard to the average consumption amounts of all monitored drugs, diclofenac was consumed the most, followed by ketorolac. Meloxicam was the least used drug. There were significant differences in the average annual consumption of ibuprofen between surgical departments, but this was not the case for the other non-opioid analgesics. The differences in the average consumption between the individual drugs were significant for each year of observation. Due to the incongruity of the results of previous studies related to non-steroidal anti-inflammatory drug consumption at different surgery wards, additional research in different geographical areas of our country is necessary to enhance the quality of prescription patterns on a national level and adjust them based on the latest scientific data and European trends.

Postoperative venous thromboembolism (VTE) represents a serious threat to patients undergoing surgical procedures. Without thromboprophylaxis, deep vein thrombosis occurs in up to 60% of patients undergoing major orthopedic surgery and 15% of patients undergoing major abdominal surgery. Although, many studies have shown the efficacy of pharmacologic and mechanical means of VTE prophylaxis, practice variations in this area abound worldwide. The purpose of this study was to determine the attitudes and practice of VTE prophylaxis of academic surgical department heads in Israel. A questionnaire covering various aspects of VTE prophylaxis was mailed to all surgical department heads of university teaching hospitals in Israel. Three months later, the same questionnaire was sent to department heads who had not yet replied. Data retrieved from the returned questionnaires were analyzed. A total of 250 departments in 23 hospitals affiliated to the four medical schools in Israel were identified; 130 department heads (52%) returned the questionnaires. The current study analyzes results obtained from the general surgical, orthopedic, urological, vascular and gynecological departments only. The total number of responses from these departments was 90 (69% response rate). Sixty-seven percent of the departments considered VTE to be a clinical problem. Ninety-four percent of departments have a policy for VTE prophylaxis. The most frequently used modalities for VTE prophylaxis (more than one option possible) were low-molecular-weight heparin (LMWH) (59%), unfractionated heparin (43%) and an intermittent pneumatic compression device (20%). VTE prophylaxis is begun 12 h preoperatively by 33% of departments, 2-4 h preoperatively by 20% of departments and with premedication by 8% of departments. VTE prophylaxis was continued during the postoperative period by all departments, with 52% stopping prophylaxis upon patient mobilization. Bleeding complications have been noted by 55% of departments, of these 9% were considered major. In general surgical, orthopedic and gynecologic departments, VTE prophylaxis was widely used for those procedures for which published guidelines exist, while considerable variation in VTE prophylaxis administration was demonstrated in a number of commonly encountered clinical situations for which there are no published recommendations. This study confirms that academic surgical departments in Israel conform to standard VTE prophylaxis guidelines. However, considerable variations in practice exist regarding the means of prophylaxis, onset of prophylaxis and its duration. These areas should be the focus of ongoing educational efforts including the development of uniform practice guidelines to improve the quality of care regarding VTE prophylaxis. Furthermore, attention should be given to methods for decreasing hemorrhage caused by LMWH and unfractionated heparin usage.

Presence of hypomagnesemia in the perioperative period can significantly increase morbidity (1). Preoperative nutritional deficiency may accompany magnesium deficiency. The aim of this study is; To investigate malnutrition by mini nutritional assessment-short form (MNA-sf) in patients scheduled for elective surgery and to examine the relationship between magnesium level, age, gender, surgical departments, BMI and ASA classification. Patients over the age of 18 who were scheduled for elective surgery were included in the study. The study was conducted with 387 patients according to statistical power analysis. In our study, magnesium level was found to be significantly lower in inverse proportion to age only in preoperative patients hospitalized in the general surgery department. It was found that the magnesium level of preoperative male patients hospitalized in the general surgery department was significantly higher than that of female patients. It was determined that the mini nutritional screening and evaluation tests showed statistically significant correlation in all surgical departments. Malnutrition is thought to have adverse effects on morbidity in the perioperative period. It may be very useful to detect malnutrition that can be detected by hypomagnesemia with a simple test beforehand.

Objective To investigate the influence of the primary diseases on the outlook of multiple organs dysfunction syndrome (MODS). Methods The investigation was a multicentre study. The clinical data of 452 MODS cases from 20 Ⅲ-level general hospitals in Northern China were analyzed with chi-square test and logistic regression analysis. The relationship of primary diseases, their distribution and prognosis of MODS was investigated. Results Mean age of patients (320 cases) who were suffering from a certain disease was (67.9±0.8) years old, which was higher than that of patients [132 cases, (46.9±1.7) years old] who did not have a primary disease (P=0.000). The mortality of patients with existing primary diseases was 56.2% (180/320), which was higher than that of the patients without a primary disease (31.1%, 41/132, P=0.000). The percent of occurrence of dysfunction of three organs was higher in patients who were suffering from some primary diseases was 74.38% (238 cases) than that of those without a primary disease (63.64%, 84 cases, P=0.022). In the patients who were suffering from cerebrovascular disease, cardiac insufficiency, chronic obstructive pulmonary disease (COPD), the incidence of complicating with dysfunction of three to four organs was respectively 63.4% (52/82), 67.1% (55/82), 69.1% (38/55), and were higher than those patients who did not have above-mentioned diseases [50.5% (187/370), 49.7% (184/370), 54.3% (201/370), all P<0.05]. Logistic regression analysis showed that cerebrovascular disease was the major risk factor. Conclusion In patients whose age is over 67 years, and at the same time they are having a primary disease, the prognosis is poor. The mortality of MODS patients with hypertension, cerebrovascular disease, cardiac insufficiency, COPD, chronic renal insufficiency is higher, and cerebrovascular disease is the major risk factor in the prognosis of MODS patients. Key words: primary disease; multiple organs dysfunction syndrome; pathogenetic condition; prognosis

Recurrence of the primary disease is a significant issue in pediatric renal transplantation (RTx). According to data reported by the North American Pediatric Renal Transplantation Cooperative Study, patients with focal segmental glomerulosclerosis (FSGS) as primary renal disease have a recurrence rate of 30% after the first RTx. The relative risk of an early graft loss because of recurrent disease is increased to 1.6-3.1 in pediatric patients with FSGS. In a German open multicenter study, which was initiated to investigate mycophenolate mofetil (MMF) after pediatric RTx [Transplantation 2001:71:638, Transplantation 2003:75:454], patients with FSGS were evaluated for recurrence rate, risk factors for recurrence, long-term graft function, glomerular filtration rate and transplant survival. All patients received immunosuppression with MMF, cyclosporine A and prednisone without induction therapy. Renal function and survival data for FSGS patients were compared with the results of patients with other primary renal diseases within the same study population. Among 86 patients transplanted between 1996 and 1999 eight patients suffered from FSGS as primary disease. Recurrence was diagnosed in two of the eight patients. One out of these two patients lost his graft as a result of recurrence. Risk factors such as time between diagnosis and end stage renal disease (ESRD) and age at onset did not predict recurrence. A three-year patient survival in the FSGS group was 100%, graft survival 87% vs. 97% in the non-FSGS group. Acute rejections occurred in three out of eight FSGS patients and in 37 out of 78 among the non-FSGS group. Long-term renal function, calculated using mathematical modeling based on glomerular filtration rate (GFR) data during 3 yr after RTx, was similar in FSGS patients - including a patient who had recurrence with a functioning graft - and those without FSGS. In patients with FSGS, recurring disease after RTx remains an important cause of graft loss (one of two patients in this population) even under modern immunosuppressants. Nevertheless, the immunosuppressive regimen used was associated with a similar graft survival rate and long-term renal function of FSGS patients compared with patients with other primary diseases.

More information is needed regarding the prognosis of children receiving home parenteral nutrition (HPN). This article describes 20-year outcome data in children receiving HPN and provides separate profiles for the major pediatric diagnostic subgroups. This retrospective study included children who started receiving HPN between January 1, 1980, and December 31, 1999, in a single pediatric HPN center. A total of 302 children were recruited, 230 (76%) with primary digestive disorders and 72 (24%) with nonprimary digestive disorders. Median age at HPN onset was 1.5 years. Median duration of HPN was 1.3 years. By January 1, 2000, 54% had weaned from HPN, 26% were still receiving HPN, 16% had died, and 4% had undergone intestinal transplantation. The survival probabilities at 2, 5, 10, and 15 years were 97%, 89%, 81%, and 72%, respectively. The likelihood and cause of death depended on the underlying diagnosis. Nine percent of children with primary digestive disorders died, 24% from their primary disease and 48% from liver disease or sepsis. Children with intractable diarrhea of infancy had the highest mortality rate (25%) and the highest incidence of liver disease (48%; P = 0.0002). Thirty-eight percent of children with primary nondigestive diseases died, 94% from their primary disease and 6% from liver disease or sepsis. Outcome and survival of children receiving HPN are mainly determined by their underlying diagnosis. Nearly all children with primary digestive disease survive if referred early to an expert center.

Table of ContentsI. IntroductionA. Development of GuidelinesB. General ApproachC. Preoperative Clinical EvaluationII. Further Preoperative Testing to Assess Coronary RiskA. Clinical MarkersB. Functional CapacityC. Surgery-Specific RiskIII. Management of Specific Preoperative Cardiovascular Condition

A total of 728 patients admitted to the medical, gynaecological and surgical departments of one urban and one rural general hospital in Austria were investigated for psychiatric morbidity. Using the Clinical Interview Schedule and its case criteria, the prevalence of psychiatric morbidity was found to be highest in medical departments (38.2%), followed by surgical departments (32.5%), and lowest in gynaecological departments (20.7%). Among medical and surgical patients, dementia and substance abuse disorders were the most frequent psychiatric categories, while in gynaecological departments neurotic disorders showed the highest frequency. For the sample as a whole, single status (i.e. unmarried, widowed or divorced), lower social class and rural catchment area of the general hospital predicted a high prevalence of psychiatric morbidity in a logistic regression analysis, while complications of childbirth, pregnancy or the puerperium, and diseases of the skin or the musculoskeletal system showed a negative association with psychiatric illness.

Background: Obesity is defined as an excess accumulation of body fat. To measure body fat accurately is difficult, but body mass index (BMI, kg/) is easily available for routine clinical use. Methods: A total of 4,966 (male; 2,580, female; 2,386) patients from January to September in 1997 and aged up to 90 years old were studied for BMI. Among these subjects, obstetric patients were excluded in our study. We calculated the BMI as weight (kg) per height squared (). The heights and weights of study subjects were obtained from anesthesia records. The BMI was analyzed by 4 different age groups: group 1 (less than 3 years), group 2 (between 3 to 7 years), group 3 (between 8 to 17 years), and group 4 (18 years or more), decade of age, 4 obesity categories according to BMI levels: underweight (less than 18 kg/), normal weight (19－24.9 kg/), overweight (25－29.9 kg/), and obese (30 kg/ or more), and surgical departments. Results: Mean BMI values of group 1, 2, 3, and 4 were 16.1 2.9 kg/, 16.2 2.4 kg/, 19.2 3.7 kg/ and 23.3 4.6 kg/ in males and 15.7 3.9 kg/, 15.8 2.7 kg/, 19.4 3.5 kg/ and 23.6 3.7 kg/ in females, respectively. According to generations, the BMI under teen-age was 16.3 2.7 kg/ and 14.3 2.9 kg/ in males and females respectively while it was between 20.4 3.3 kg/ to 25.0 3.6 kg/ from 1st to 7th decade patients in both sex. The prevalence of overweight and obesity were nearly zero in group 1 and 2, but males in group 3 had them of 4.6% and 1.4% while 6.9% and 0.8% in females, respectively. In group 4 they were 25.3% and 2.2% in males and 28.8% and 4.8% in females, respectively. Obese patients increased in the order of neurosurgery, gynecology, orthopedic surgery, urology, and general surgery departments. Conclusions: This study revealed the guidelines of BMI of operating patients. We recognized that the prevalence of overweight and obesity of preschool aged and adolescent patients were nearly zero. Adult patients were the highest at 4th decade in males and 6th decade in females and the obesity rates were 27.4% and 33.6% in males and females, respectively.

The nature of COVID-19 transmission creates significant risks in surgical departments owing to the close contact of medical staff with patients, the limited physical environment of the operating room and recovery room, the possibility of shared surgical equipment and challenges in the delivery of surgical care in all surgical departments. Globally, studies have reported that the effects of the pandemic on surgical departments are profound, potentially long-lasting and extensive. To manage these effects, different local guidelines and recommendations have been developed, with potential differences in their effectiveness and implementation. Therefore, harmonized and effective national/international guidelines for specific surgical departments during perioperative periods are pertinent to curtail the infection, and will inevitably need to be adapted for consistent and sustainable implementation by all medical staff. The pattern of surgical patient care during the COVID-19 pandemic at Jimma Medical Center (JMC), Ethiopia, has not been explored yet. The present study aimed to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC. A cross-sectional study was conducted to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC, using five-point Likert scales (0, not at all; 1, rarely; 2, sometimes; 3, most of the time; 4, frequently). A total of 90 respondents [35 patients (five patients from each of seven surgical departments) and 55 healthcare providers (six professionals from each of nine units, including the center of sterility room and anesthesia)] who were available during the study period, selected by a convenience sampling technique with multistage clustering, participated in the study. Data were collected using a structured questionnaire via direct observation and face-to-face interviews with patients undergoing surgery, healthcare providers and hospital administrators, against the standard surgical patient care guidelines. The collected data were manually checked for missing values and outliers, cleared, entered into EpiData (v4.3.1) and exported to SPSS (v22) for analysis. The mean score of practice was compared among different disciplines by applying the unpaired t-test. The findings of the study were reported using tables and narration. A p-value of less than 0.05 was declared as statistically significant. Despite the surgical care practice having changed during the COVID-19 pandemic in all service domains, it is not implemented consistently among different surgical departments owing to different barriers (lack of training on the updated guidelines and financial constraints). The majority of surgical staff were implementing the use of preventive measures against COVID-19, while they were practiced less among patients. The guidelines for surgical practice during the preoperative phase were well applied, especially screening patients by different methods and the application of telemedicine to reduce physical contacts. But, against guidelines, elective patients were planned and underwent surgery, especially in the general surgery department. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. The extent of practice for anesthesia care, operating room management and postoperative care in the recovery room also changed, and the guidelines were sometimes applied. Although perioperative surgical care practice differed before and during the pandemic, the standard guidelines were inconsistently implemented among surgical departments. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. Thus, the authors developed safe surgical care guidelines throughout the different domains (infection prevention and PPE use; preoperative care, intraoperative care, operating room management, anesthesia care, equipment handling process and postoperative care) for all disciplines and shared them with all staff. We recommend that all surgical staff should access these guidelines and strictly adhere to them for surgical service during the pandemic.