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. 2021 Jul 31;10(1):112.
doi: 10.1186/s13756-021-00982-z.

Impact of a total lockdown for pandemic SARS-CoV-2 (Covid-19) on deep surgical site infections and other complications after orthopedic surgery: a retrospective analysis

Ines Unterfrauner  1   2 , Laura A Hruby  3 , Peter Jans  4 , Ludwig Steinwender  5 , Mazda Farshad  3 , Ilker Uçkay  5   6
Affiliations

Impact of a total lockdown for pandemic SARS-CoV-2 (Covid-19) on deep surgical site infections and other complications after orthopedic surgery: a retrospective analysis

Ines Unterfrauner et al. Antimicrob Resist Infect Control. .

Abstract

Background: A 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.

Methods: In 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.

Results: 5791 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.

Conclusion: The 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.

Keywords: Covid-19; Deep surgical site infections; First epidemic wave; Healthcare-associated infections; Orthopedic surgery; Pandemic; Postoperative complications; SARS-CoV-2; Total lockdown; Wound healing disorders.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The epidemic curve of the first wave of Covid-19 in Switzerland. Adapted from reference [3]
Fig. 2
Fig. 2
Flowchart of the analyses. SSI = surgical site infection; wound healing disorders = substantial necrosis, uninfected dehiscence and/or hematoma necessitating surgical drainage; other complications = recurrence of disease, residual symptoms and/or intervention-specific complications
See this image and copyright information in PMC

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