https://doi.org/10.4081/monaldi.2023.2604

The impact of COVID-19 prevention measures on surgical wound infection rates post-cardiac surgery

Early Access
Submitted: April 12, 2023
Accepted: June 10, 2023
Published: October 12, 2023
Cardiac surgery, wound infection, COVID-19, infection control, postoperative complications
Abstract Views: 321
PDF_early view: 166
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Authors

Aladdin Bashir
aladdin.bashir@nhs.net
https://orcid.org/0000-0002-9327-6043
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Matthew Holmes
https://orcid.org/0000-0003-0831-2941
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Nebumathew Suresh
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Pedram Panahi
https://orcid.org/0000-0002-1601-4920
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Sameh Atta
https://orcid.org/0000-0003-0044-9003
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Hannah T. Perkins
https://orcid.org/0000-0003-3067-8907
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Clinton Lloyd
https://orcid.org/0009-0006-3858-0444
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.
Sanjay Asopa
University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom.

The COVID-19 pandemic had a huge impact on medical services. Several measures have been implemented to reduce the risk of viral transmission. In this paper, we assessed the impact of these measures on surgical wound infection rates in patients post-cardiac surgery. Hypothesis testing was used to compare post-cardiac operation infection rates between the year prior to the COVID-19 pandemic being declared and the first 13 months of the pandemic. The infection rates in 969 patients with operations between 01/03/2019 and 29/02/2020 were compared to those of 925 patients with cardiac surgery between 01/03/2020 and 31/03/2021. Infection rates for various operative urgencies and infection types were analysed. To compare infection rates, a two-tailed pooled z-test using the difference in infection proportions was performed. A 5% significance level was used and only categories with at least 10 patients in both the pre-covid and covid populations were tested. For leg infections, only operations involving coronary artery bypass grafting were included. To ensure that any differences in outcomes were not due to differences in patient demographics resulting in unequal operative risks, Euroscore II values, a measure of cardiac operative risk, were compared between the pre-covid and post-covid cohorts. The Mann-Whitney U-test was used to determine whether the distributions of Euroscore II values were likely to be drawn from the same population. A significance level of 5% was used. A total of 1901 patients (932 during the COVID-19 pandemic) were included in this study. Significant reduction in post-operative infections for all patients undergoing cardiac surgery from 4.3% of patients before COVID to 1.5% during the pandemic. During the pandemic, fewer elective and more urgent operations were performed. This study suggests a significant role of iatrogenic causes in wound infections prior to the pandemic. The implementation of COVID-19 prevention measures in healthcare providers can reduce surgical infection rates. As COVID-19-related restrictions have been eased, we suggest maintaining them in healthcare providers to reduce the incidence of surgical wound infections.

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Ethics Approval

The study protocol was approved by the Audit, Assurance & Effectiveness Team of the University Hospitals of Plymouth

How to Cite

Bashir, Aladdin, Matthew Holmes, Nebumathew Suresh, Pedram Panahi, Sameh Atta, Hannah T. Perkins, Clinton Lloyd, and Sanjay Asopa. 2023. “The Impact of COVID-19 Prevention Measures on Surgical Wound Infection Rates Post-Cardiac Surgery”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2023.2604.
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