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Abstract
BackgroundA total lockdown for pandemic SARS-CoV-2 (Covid-19) entailed a restriction of elective orthopedic surgeries in Switzerland. While access to the hospital and human contacts were limited, hygiene measures were intensified. The objective was to investigate the impact of those strict public health guidelines on the rate of intra-hospital, deep surgical site infections (SSI), wound healing disorders and non-infectious postoperative complications after orthopedic surgery during the first Covid-19 lockdown.MethodsIn a single-center study, patients with orthopedic surgery during the first Covid-19 lockdown from March 16, 2020 to April 26, 2020 were compared to cohorts that underwent orthopedic intervention in the pre- and post-lockdown periods of six months each. Besides the implementation of substantial public health measures (promotion of respiratory etiquette and hand hygiene), no additional infection control bundles have been implemented.Results5791 patients were included in this study. In multivariate Cox regression analyses adjusting for the large case-mix, the lockdown was unrelated to SSI (hazard ratio (HR) 1.6; 95% confidence interval (CI) 0.6–4.8), wound healing disorders (HR 0.7; 95% CI 0.1–5.7) or other non-infectious postoperative complications (HR 0.7, 95% CI 0.3–1.5) after a median follow-up of seven months.ConclusionThe risks for SSI, wound healing disorders and other complications in orthopedic surgery were not influenced by the extended public health measures of the total Covid-19 lockdown.Trial registration BASEC 2020–02646 (Cantonal Ethics Commission Zurich).Level of evidence: Level III.
Highlights
A total lockdown for pandemic SARS-CoV-2 (Covid-19) entailed a restriction of elective orthopedic surgeries in Switzerland
With an increased awareness of viral infections in the community and hospitals, we hypothesized that those public health bundles yielded a positive impact on classical postoperative complications such as deep surgical site infections (SSI), other healthcare-associated infections (HAI), postoperative complications, and on the observed hand hygiene (HH) compliance [4]
Study population Within the one-year study period, 5791 orthopedic interventions were performed with a median follow-up of 218 days (SD 118) after the index surgery
Summary
A total lockdown for pandemic SARS-CoV-2 (Covid-19) entailed a restriction of elective orthopedic surgeries in Switzerland. The objective was to investigate the impact of those strict public health guidelines on the rate of intrahospital, deep surgical site infections (SSI), wound healing disorders and non-infectious postoperative complications after orthopedic surgery during the first Covid-19 lockdown. The Covid-19 pandemic led to intensified hygiene awareness and measures with increased hand-rubbing and constant use of surgical masks and gloves. With an increased awareness of viral infections in the community and hospitals, we hypothesized that those public health bundles yielded a positive impact on classical postoperative complications such as deep surgical site infections (SSI), other healthcare-associated infections (HAI), postoperative complications, and on the observed hand hygiene (HH) compliance [4]
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