Does use of intra-operative PPE affect post-operative infection rates in hip fracture patients?

ABSTRACT

Aim: COVID-19 has required significant change to theatre protocol. Regional guidelines dictate full PPE must be donned for all procedures where aerosol generating procedures (AGP) occur. Additionally, no one may enter or leave theatre whilst an operation is in progress, or until 20 minutes after an AGP. We hypothesized that adopting these protocols may lead to a reduction in post-operative infection in hip fracture patients. Method: Multicentre retrospective cohort study comparing post-operative infection and return to theatre rates (<30-days post-op) from 18/ 03/20 to 27/04/20 with respective period in 2019. COVID-19 was considered endemic in Northern Ireland from 18/03/20. Patients were identified from the Fracture Outcomes Research Department database and relevant inpatient episode reviewed via Electronic Care Record. Results: 464 patients were included- 261(2020) and 203(2019). In 2019, 4 patients (1.5%) returned to theatre within 30-days, however only one was due to wound dehiscence. In 2020, 1 patient (0.5%) returned to theatre for traumatic wound dehiscence, however they had no documented infection. Conclusions: There was no difference in post-operative complication rate requiring return to theatre within 30 days between cohorts. Whilst PPE can be considered important for protection of patients and staff against COVID-19, it may not have significant effect on post-operative infection rates.