The strategies of perioperative management in orthopedic department during the pandemic of COVID-19

Abstract

Background Coronavirus disease 2019 (COVID-19) has broken out and spread rapidly nationwide at the beginning of 2020, which has brought huge impacts to people and work. The current situation of prevention and control is severe and urges guidance for clinicians, especially for medical systems. In the hope of providing a reference and recommendation for the prevention and control of the COVID-19, we carried out research to improve the quality of patient care and prevention during this epidemic. Methods All of the staff were trained rapidly to master personal protection in our department. We reviewed the patients’ discharged records who underwent surgery in our department during January 1 to March 1, 2019, and January 1 to March 1, 2020. The management of the surgery patients and flow charts were described and analyzed. Post-operation outcomes of the patients include duration, complications, surgical site infection (SSI), system infection, re-operation, and mortality. Both chi-squared test and Student’s t test were performed to determine the relationship between the two periods in terms of post-operation outcomes. Results Descriptive statistics analysis revealed that demographic of the patients between the two periods is similar. We had benefited from the strict flowcharts, smart robot, and protection equipment during the perioperative managements for orthopedic patients. With the help of the strict flow charts and smart equipment, post-operation outcomes of the patients revealed that the rates of the complications and re-operation had been reduced significantly (p < 0.05), while duration of operation, SSI, and system infection had no significant difference between two periods (p > 0.05). No patient and staff caught COVID-19 infection or mortality during the epidemic. Conclusions Our study indicated that medical quality and efficiency were affected little with the help of strategies described above during the epidemic, which could be a reference tool for medical staff in routine clinical practice for admission of patients around the world. What is more, the provided strategies, which may evolve over time, could be used as empirical guidance and reference for orthopedic peers to get through the pandemic and ensure the normal operation of the hospital.

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

“…Similar to our findings, other research groups found the same SSI and overall HAI risk before and during the lockdown periods [ 20 ] or even a possible increase of urinary tract or catheter infections [ 16 ]. However, this analysis included much lower patient numbers, considered the time period of Covid-19 spread and not of lockdown guidelines and did not contain a multivariate analysis to adjust for influencing variables.…”

“…It would be of great interest to link an observed HH compliance to the incidence of HAI during the pandemic wave [ 7 , 8 , 18 – 20 ]. In the Covid-19 era, unfortunately, many publications supporting HH do not provide own HAI data, and vice versa.…”

Short-term outcomes of enhanced recovery after surgery (ERAS) for ankle fracture: a single-center retrospective cohort study

“…For the part of the ankle fracture, it would cause immediate stress reaction and adverse impact on the patients in return, such as catabolism, thrombosis, neuroendocrine and immune system dysfunction, or even collapse of cardiovascular and respiratory system [21]. However, implementation of the ERAS protocol based on the standardization process would bene t patients by releasing pain or stress [22,23].…”

EACTA/SCA Recommendations for the Cardiac Anesthesia Management of Patients With Suspected or Confirmed COVID-19 Infection: An Expert Consensus From the European Association of Cardiothoracic Anesthesiology and Society of Cardiovascular Anesthesiologists With Endorsement From the Chinese Society of Cardiothoracic and Vascular Anesthesiology

“…There are several published consensus statements ( 4 ) ( 5 ) ( 6 ) and joint recommendations on the perioperative management of COVID-19 patients during different varieties of surgery ( 7 ) ( 8 ) EACTA and SCA believe that is important to develop this joint-consensus for the perioperative management of patients undergoing cardiac surgery and minimally invasive cardiac interventions during the COVID-19 pandemic, based on the best evidence available until now. First, this consensus could serve as a guide to cardiac anesthesiologists in light of continuing cardiovascular care delivery services during the evolving second and perhaps subsequent waves of COVID-19.…”