scholarly journals Orthopaedic patients’ perceptions about their pre-operative information

Curationis ◽  
2009 ◽  
Vol 32 (4) ◽  
Author(s):  
C. Chetty ◽  
V.J. Ehlers
Keyword(s):  
Orthopaedic Surgery ◽  
Elective Surgery ◽  
Pain Medication ◽  
Deep Breathing ◽  
Quantitative Survey ◽  
Orthopaedic Patients ◽  
Kwazulu Natal ◽  
Preoperative Information

A non-experimental, descriptive and quantitative survey was conducted to explore orthopaedic patients’ perceptions about the pre-operative information received when undergoing elective surgery in two hospitals in the KwaZulu-Natal Province. The findings indicate that most patients perceived the pre-operative information to be useful in their preparation for surgery. Aspects that were not addressed during preoperative information sessions included post-operative nutrition, pain medication, ambulation, deep breathing and coughing exercises. The recommendations include that all these aspects should be addressed in future pre-operative education sessions. Further research should be conducted for enhancing the pre-operative information provided to patients scheduled to undergo elective orthopaedic surgery.

scholarly journals Elective orthopaedic surgery with a designated COVID-19-free pathway results in low perioperative viral transmission rates

2020 ◽  
Vol 1 (9) ◽  
pp. 562-567 ◽  
Author(s):  
Justin S. Chang ◽  
Warran Wignadasan ◽  
Raj Pradhan ◽  
Christina Kontoghiorghe ◽  
Babar Kayani ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Elective Surgery ◽  
Transmission Rate ◽  
Patient Characteristics ◽  
Viral Transmission ◽  
Transmission Rates ◽  
Orthopaedic Patients ◽  
Grade Ii ◽  
American Society ◽  
A Prospective Study

Aims The safe resumption of elective orthopaedic surgery following the peak of the COVID-19 pandemic remains a significant challenge. A number of institutions have developed a COVID-free pathway for elective surgery patients in order to minimize the risk of viral transmission. The aim of this study is to identify the perioperative viral transmission rate in elective orthopaedic patients following the restart of elective surgery. Methods This is a prospective study of 121 patients who underwent elective orthopaedic procedures through a COVID-free pathway. All patients underwent a 14-day period of self-isolation, had a negative COVID-19 test within 72 hours of surgery, and underwent surgery at a COVID-free site. Baseline patient characteristics were recorded including age, American Society of Anaesthesiologists (ASA) grade, body mass index (BMI), procedure, and admission type. Patients were contacted 14 days following discharge to determine if they had had a positive COVID-19 test (COVID-confirmed) or developed symptoms consistent with COVID-19 (COVID-19-presumed). Results The study included 74 females (61.2%) and 47 males (38.8%) with a mean age of 52.3 years ± 17.6 years (18 to 83 years). The ASA grade was grade I in 26 patients (21.5%), grade II in 70 patients (57.9%), grade III in 24 patients (19.8%), and grade IV in one patient (0.8%). A total of 18 patients (14.9%) had underlying cardiovascular disease, 17 (14.0%) had pulmonary disease, and eight (6.6%) had diabetes mellitus. No patients (0%) had a positive COVID-19 test in the postoperative period. One patient (0.8%) developed anosmia postoperatively without respiratory symptoms or a fever. The patient did not undergo a COVID-19 test and self-isolated for seven days. Her symptoms resolved within a few days. Conclusion The development of a COVID-free pathway for elective orthopaedic patients results in very low viral transmission rates. While both surgeons and patients should remain vigilant, elective surgery can be safely restarted using dedicated pathways and procedures. Cite this article: Bone Joint Open 2020;1-9:562–567.

scholarly journals 905 How to prioritise patients and safely resume elective surgery during the Covid-19 pandemic

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Subbiah Ponniah ◽  
M Ahmed ◽  
T Edwards ◽  
J Cobb ◽  
E Dean ◽  
...  
Keyword(s):  
Patient Safety ◽  
High Risk ◽  
Orthopaedic Surgery ◽  
Elective Surgery ◽  
Paediatric Patients ◽  
Level 3 ◽  
Level 1 ◽  
Surgical Unit

Abstract Introduction There are now over 2.5 million NHS patients awaiting elective surgery, with the most in orthopaedics. We present an algorithm and results for safely and equitably restarting surgery at COVID-light sites. Method An MDT applied the COVID-19 Algorithm for Resuming Elective Surgery (CARES) on 1169 patients awaiting elective orthopaedic surgery. It assessed safety, procedural efficacy, and biopsychosocial factors, to prioritise patients. They were assigned to five categories and underwent surgery at one of three COVID-light sites (1. access to HDU/ITU/Paediatrics/specialist equipment, 2. an NHS elective surgical unit and 3. a private elective surgical unit). Results 21 ‘Urgent’ patients received expedited care; 118 were Level 1/2; 222 were Level 3; 808 were Level 4. In 6 weeks, 355 surgeries were performed, with Urgent and Level 1/2 cases performed soonest (mean 18 days, p < 0.001). 33 high-risk/complex/paediatric patients had surgery at Site 1 and the rest at Sites 2 and 3. No patients contracted COVID-19 within 2 weeks of surgery. Conclusions We validated a widely generalisable model to facilitate resumption of elective surgery in COVID-light sites. It enabled surgery for patients in most suffering, undergoing the most efficacious procedures and/or at highest risk of deterioration, without compromising patient-safety.

scholarly journals Trends in orthopaedic antimicrobial prophylaxis in the UK between 2005 and 2011

2013 ◽  
Vol 95 (7) ◽  
pp. 495-502 ◽  
Author(s):  
RS Aujla ◽  
DJ Bryson ◽  
A Gulihar ◽  
GJ Taylor
Keyword(s):  
Orthopaedic Surgery ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Elective Surgery ◽  
Antimicrobial Prophylaxis ◽  
Trauma Surgery ◽  
Surgical Site Infections ◽  
Freedom Of Information ◽  
Infection Rates ◽  
Freedom Of Information Act ◽  
The Uk

Introduction Antimicrobial prophylaxis remains the most powerful tool used to reduce infection rates in orthopaedics but the choice of antibiotic is complex. The aim of this study was to examine trends in antimicrobial prophylaxis in orthopaedic surgery involving the insertion of metalwork between 2005 and 2011. Methods Two questionnaires (one in 2008 and one in 2011) were sent to all National Health Service trusts in the UK using the Freedom of Information Act. Results In total, 87% of trusts that perform orthopaedic surgery responded. The use of cefuroxime more than halved between 2005 and 2011 from 80% to 36% and 78% to 26% in elective surgery and trauma surgery respectively. Combination therapy with flucloxacillin and gentamicin rose from 1% to 32% in elective and 1% to 34% in trauma surgery. Other increasingly popular regimes include teicoplanin and gentamicin (1% to 10% in elective, 1% to 6% in trauma) and co-amoxiclav (3% to 8% in elective, 4% to 14% in trauma). The majority of changes occurred between 2008 and 2010. Over half (56%) of the trusts stated that Clostridium difficile was the main reason for changing regimes. Conclusions In 2008 a systematic review involving 11,343 participants failed to show a difference in surgical site infections when comparing different antimicrobial prophylaxis regimes in orthopaedic surgery. Concerns over C difficile and methicillin resistant Staphylococcus aureus have influenced antimicrobial regimes in both trauma and elective surgery. Teicoplanin would be an appropriate choice for antimicrobial prophylaxis in both trauma and elective units but this is not reflected in its current level of popularity.

scholarly journals Dealing with the COVID-19 pandemic in orthopaedics: experiences and procedure in Germany

2020 ◽  
Vol 1 (6) ◽  
pp. 309-315 ◽  
Author(s):  
Michael Mueller ◽  
Friedrich Boettner ◽  
Daniel Karczewski ◽  
Viktor Janz ◽  
Stephan Felix ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Clinical Symptoms ◽  
Elective Surgery ◽  
Infection Status ◽  
Clinical Experiences ◽  
Suction System ◽  
Free Zone ◽  
Orthopaedic Patients ◽  
Laminar Air Flow ◽  
Basis Class

Aims The worldwide COVID-19 pandemic is directly impacting the field of orthopaedic surgery and traumatology with postponed operations, changed status of planned elective surgeries and acute emergencies in patients with unknown infection status. To this point, Germany's COVID-19 infection numbers and death rate have been lower than those of many other nations. Methods This article summarizes the current regimen used in the field of orthopaedics in Germany during the COVID-19 pandemic. Internal university clinic guidelines, latest research results, expert consensus, and clinical experiences were combined in this article guideline. Results Every patient, with and without symptoms, should be screened for COVID-19 before hospital admission. Patients should be assigned to three groups (infection status unknown, confirmed, or negative). Patients with unknown infection status should be considered as infectious. Dependent of the infection status and acuity of the symptoms, patients are assigned to a COVID-19-free or affected zone of the hospital. Isolation, hand hygiene, and personal protective equipment is essential. Hospital personnel directly involved in the care of COVID-19 patients should be tested on a weekly basis independently of the presence of clinical symptoms, staff in the COVID-19-free zone on a biweekly basis. Class 1a operation rooms with laminar air flow and negative pressure are preferred for surgery in COVID-19 patients. Electrocautery should only be utilized with a smoke suction system. In cases of unavoidable elective surgery, a self-imposed quarantine of 14 days is recommended prior to hospital admission. Conclusion During the current COVID-19 pandemic, orthopaedic patients admitted to the hospital should be treated based on an interdisciplinary algorithm, strictly separating infectious and non-infectious cases. Cite this article: Bone Joint Open 2020;1-6:309–315.

BODY MASS INDEX OF ORTHOPAEDIC SURGICAL PATIENTS IN JEJU — DOES IT REFLECT THE KOREANS’ NUTRITIONAL STATUS

2020 ◽  
pp. 2050022
Author(s):  
Myung-Sang Moon ◽  
Bum Soo Kim ◽  
Seong-Tae Kim ◽  
Won Rak Choi ◽  
Hyeon Gyu Lim
Keyword(s):  
Body Mass Index ◽  
General Population ◽  
Body Mass ◽  
Elective Surgery ◽  
Normal Weight ◽  
Surgical Patients ◽  
Living Standard ◽  
Orthopaedic Patients ◽  
Obesity Status ◽  
Nutritional Studies

Purpose: To assess the preoperative body mass indices of various orthopaedic conditions, there are a few previous nutritional studies in surgical patients, and none did solely the BMI study in general population in Korea. The current authors planned indirectly to evaluate the Koreans’ obesity. Methods: BMI was used to assess the obesity status of the 2063 orthopaedic patients who were subjected to surgeries; 1272 fractures, 490 various elective surgeries, 232 arthroplasties, 59 musculoskeletal infections, and 10 uninfected diabetics, in Jeju island. Results: Among total 2063 patients, 101 patients (4.8%) had underweight, normal weight in 1220 patients (59.1%), overweight in 630 (30.5%), and the so-called “obese” in 124 cases (6.0%). The obesity in detail of each group is listed in Table 2–6. Among 1272 fracture cases, underweight in 79 (6.2%), normal weight in 752 (61.5%), overweight in 345 (27.1%), and overall class I–III obese in 66 (5.1%). 490 elective surgery patients had overweight in 34.5% and obese in 7.1%. The incidences of obesity in each condition are nearly similar, ranging from 5.2% to 7.3% except for the diabetic one. Conclusions: This study on BMI of the orthopaedic patients disclosed that the incidence of obesity is not high yet in Jeju islanders, in spite of the highly improved living standard.

scholarly journals Orthopaedic surgery after COVID-19 – A blueprint for resuming elective surgery after a pandemic

2020 ◽  
Vol 80 ◽  
pp. 162-167 ◽  
Author(s):  
Benjamin Tze Keong Ding ◽  
Kelvin Guoping Tan ◽  
Jacob Yoong-Leong Oh ◽  
Keng Thiam Lee
Keyword(s):  
Orthopaedic Surgery ◽  
Elective Surgery

The impact of the novel coronavirus on trauma and orthopaedics in the UK

2020 ◽  
Vol 81 (4) ◽  
pp. 1-6 ◽  
Author(s):  
Catrin Morgan ◽  
Aashish K Ahluwalia ◽  
Arash Aframian ◽  
Lily Li ◽  
Stephen Ng Man Sun
Keyword(s):  
Orthopaedic Surgery ◽  
Musculoskeletal Injury ◽  
The Novel ◽  
Front Line ◽  
Orthopaedic Patients ◽  
Novel Coronavirus ◽  
Injury Burden ◽  
The Uk ◽  
The Impact ◽  
British Orthopaedic Association

At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.

scholarly journals Perioperative Prophylactic Antibiotics in Orthopaedic Surgery

2013 ◽  
Vol 3 (1) ◽  
pp. 5-10
Author(s):  
Bikram Prasad Shrestha ◽  
Surya Raj Niraula ◽  
Parvin Nepal ◽  
Guru Prasad Khanal ◽  
Navin Karn ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Drug Resistant ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Randomized Controlled ◽  
Orthopaedic Patients ◽  
Significant Difference

Introduction: In our country, various institutes have different protocols for postoperative antibiotics. Many western literature have mentioned that administration of prophylactic antibiotics for longer than 24 hours has no advantage and may actually lead to superinfection with drug-resistant organisms. Because of environmental and theater condition most of the surgeon here are very reluctant to use prophylactic antibiotics for only 24 hours. The objective of the study was to find out the effect of duration of prophylactic antibiotics on the rate of surgical site infection in clean elective orthopaedic surgeries. Methods: This was a randomized controlled trial involving 207 clean elective orthopaedic patients undergoing surgery. The patients were divided into three groups which received intravenous prophylactic antibiotics for 24 hours, 48 hours and 48 hours followed by 7 days of oral antibiotics respectively. The patients were followed up for three months postoperatively. Result: There was no significant difference in the rate of surgical site infection among the three groups. Conclusion: We conclude that there is no benefit in prolonging prophylactic antibiotics beyond 24 hours. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9318   Nepal Orthopedic Association Journal 2013 Vol.3(1): 5-10

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