Article
Surgical site infection during COVID-19 times – Did the paradigm shift of the hygiene measures affect the rate of SSI in neurosurgical patients?
Wundheilungsstörung während COVID-19 – Hat der Paradigmenwechsel bei den Hygienemaßnahmen die Häufigkeit von Wundheilungsstörungen bei neurochirurgischen Patienten beeinflusst?
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Authors
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Tatiana Chacón Quesada
- Universitätsmedizin Göttingen, Nuerochirurgie, Göttingen, Deutschland
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Veit Rohde
- Universitätsmedizin Göttingen, Neurochirurgie, Göttingen, Deutschland
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Christian von der Brelie
- Universitätsmedizin Göttingen, Neurochirurgie, Göttingen, Deutschland
| Published: | June 4, 2021 |
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Outline
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Objective: Hygiene measures were intensified when the COVID-19 pandemic began. Patient contacts were limited to a minimum. Visitors were either not allowed for a certain period or limited for the rest of the time. The hospital staff began to wear masks and gloves continuously. Clinical examinations and routine wound controls were also performed under intensified hygiene standards. These circumstances result in a limitation of direct physical interactions between the nursing staff, the physicians and the patients.
We analyzed to what extent the intensification of hygiene measures affect the rate of surgical site infections (SSI) after neurosurgical procedures.
Methods: The rate of SSI during the six month interval of COVID-19 measures was compared with the SSI rate before. The numbers of the period before COVID-19 were analyzed as mean values resulting from the analysis of two separate time periods each consisting of six months. The spectrum of surgical procedures was compared. Patient related risk factors for SSIs were noted. Microorganisms were analyzed. We focused on SSIs occurring at maximum 60 days after the primary surgery.
Results: Overall, in the respective six months periods before COVID-19, a mean of 1379 patients were surgically treated in our institution. After the beginning of COVID-19 (starting from 03/2020) our surgical numbers only dropped by 23, resulting in a total number of 1356 patients being operated after 03/2020 until 09/2020. The SSI rate was 3.6% (03/2019 – 09/2019, 50 SSIs) and 2.1% (09/2019 – 03/2020, 29 SSIs), resulting in a mean of 2.9% before COVID-19 began. After the beginning of COVID-19 hygiene measures this rate dropped to 1.2% (17 SSIs). Risk factors for development of SSI were present in 67% of all patients. Comparison of pre- and post COVID-19 groups revealed no difference (p=0.15). The site of SSIs did not differ regarding cranial and spinal procedures comparing the time intervals pre- and post COVID-19 (p=0.08). Comparing the number (p=0.36) and the species (p=0.47) of microorganisms (MO) causing SSI, we found a similar distribution.
Conclusion: Despite equal demographics and characteristics of SSI, the rate of SSI dropped dramatically. This argues for an effective reduction of postoperative SSI resulting from the implementation of strict hygiene measures being established after the beginning of the COVID-19 pandemic. We therefore advocated continuing with the strict hygiene measures in the future.
