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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, Laura A Hruby, Peter Jans, Ludwig Steinwender, Mazda Farshad & Ilker Uckay

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.
   
citation Unterfrauner I, Hruby L A, Jans P, Steinwender L, Farshad M, Uckay I. 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. Antimicrob Resist Infect Control 2021; 10:112.
   
type journal paper/review (English)
date of publishing 31-07-2021
journal title Antimicrob Resist Infect Control (10/1)
ISSN electronic 2047-2994
pages 112
PubMed 34332632
DOI 10.1186/s13756-021-00982-z