Background The novel coronavirus, now termed SARS-CoV-2, has had a significant impact on cardiac surgical services globally. Although drastically reduced, our institution has maintained a significant level of cardiac surgical activity during the pandemic. Rigorous COVID-19 guidelines have been instituted to mitigate the risk of viral transmission. We observed a reduction in sternal wound infections since the institution of new perioperative surgical guidelines. Methods We performed a retrospective analysis of all patients who underwent cardiac surgery at our institution since a national lockdown was declared in March 2020. A retrospective analysis of all patients who underwent cardiac surgery in the 12 months preceding the national lockdown, as a baseline cohort group, was also performed. Results A total of 2600 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. During the COVID-19 pandemic, there were 4 sternal wound infections with an overall incidence of 0.8%. In comparison, the incidence of sternal wound infections was significantly higher at 3.0% in the 12-month period prior to lockdown with 63 sternal wound infections ( p = 0.006). Conclusion This report suggests a significant role of iatrogenic causes in sternal wound infections prior to the pandemic. The strict implementation of guidelines in the perioperative period suggests that sternal wound infections can be prevented. We propose that the now widespread COVID-19 guidelines to reduce transmission risk be adapted to help reduce the incidence of sternal wound infections.

BackgroundExperiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers (HCWs). This may have serious consequences for the overall well-being of HCWs, which in turn may adversely affect patient safety and the productivity of the institution.AimsWe designed a study to assess the prevalence of generalised anxiety disorder (GAD), depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.MethodsAn anonymous survey was designed with demographic data and three questionnaires. The Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depression, respectively. The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress. Staff from multiple specialties embracing cardiothoracic surgery, cardiology, respiratory medicine, endocrinology, oncology, imaging, anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.ResultsA total of 302 staff members (106 males and 196 females) completed the survey. The overall prevalence of GAD and depression was 41.4% and 42.7%, respectively. The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant. Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors. Work-related stress was also observed to be prevalent in our surveyed population with the following standards: relationships, role, control and change showing a need for improvement.ConclusionsOur study presents early evidence suggestive of a high prevalence of GAD, depression and work-related stress in HCWs. It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.

Introduction During the COVID pandemic, the 2019-2020 cohort of final year students were invited to participate in Foundation interim Year 1 placements (FiY1). FiY1 aimed to ease transition to Foundation Year 1 doctor (FY1). We assessed the psychological impact of FiY1 on final year medical students. Method A cross-sectional survey was distributed to final year medical students in the UK between June 4th and July 4th, 2020. The survey contained the following domains: participant demographics, rationale for FiY1 participation, a checklist of the key safety principles for FiY1s, the Hospital Anxiety and Depression Scale and the Perceived Stress scale-4. Results 107 final years responded to the survey. 72.0% (n = 77) of final year students surveyed were working as FiY1s. Final year students participating in FiY1 postings had reduced rates of anxiety (29.9% vs 43.4%, P = 0.186), depression (5.2% vs 20.0%, P = 0.018) and lower perceived stress levels (5.0 vs 7.2, P < 0.001). 19.5% (15/77) FiY1s reported working beyond their competency, 27.3% (22/77) felt unsupervised, but 94.8% (73/77) of FiY1s felt the post prepared them for FY1. Conclusions Students participating in FiY1 postings felt less stressed and depressed than those not participating in the scheme and the majority felt it was preparing them for FY1.

We therefore set up targeted cadaveric dissections and cadaveric simulation-teaching model for radiology residents with two objectives: first, to restore three-dimensional knowledge of surgical anatomy with specific regional anatomy focus; second, to familiarise radiology residents with interventional radiology. | WHAT WAS TRIED?We developed a laboratory course with three 3-h fresh-frozen cadaveric dissection sessions and one 4-h cadaveric practical training session. This elective course was intended for 5 to 10 radiology residents

Introduction With advances in technology, virtual clinics are becoming increasingly attractive as a tool for outpatient follow up care. During the COVID-19 pandemic, the implementation of virtual outpatient clinics was crucial, for continued service provision despite social distancing guidelines. We aimed to ascertain patient satisfaction with virtual clinics in cardiothoracic surgery. Method Forty patients who attended virtual clinics, post cardiothoracic surgery, were invited to provide feedback by means of a questionnaire. Feedback was gathered by junior doctors. Results Thirty-four patients (20 had never had a telephone clinic appointment) agreed to provide feedback. Fifty percent of patients had not been seen since their operation. 91.2% (n = 31) of patients felt that the telephone consultation met their expectations/needs. Patient reported advantages of telephone consultations included: less concern regarding exposure to infection, no concern regarding parking, no travel time and less time off work. 79.4% (n = 27) would have preferred a face-to-face appointment. Patient reported disadvantages of telephone consultations were poor reception, felt they weren’t listened to and would have preferred to have been physically examined. Conclusions Patients were satisfied with telephone clinics for routine follow up post cardiothoracic surgery. However, the majority would have preferred face to face appointments.