COVID-19 has changed the practice of orthopaedics across the globe. The medical workforce has dealt with this outbreak with varying strategies and adaptations, which are relevant to its field and to the region. As one of the ‘hotspots’ in the UK , the surgical branch of trauma and orthopaedics need strategies to adapt to the ever-changing landscape of COVID-19. Adapting to the crisis locally involved five operational elements: 1) triaging and workflow of orthopaedic patients; 2) operation theatre feasibility and functioning; 3) conservation of human resources and management of workforce in the department; 4) speciality training and progression; and 5) developing an exit strategy to resume elective work. Two hospitals under our trust were redesignated based on the treatment of COVID-19 patients. Registrar/consultant led telehealth reviews were carried out for early postoperative patients. Workflows for the management of outpatient care and inpatient care were created. We looked into the development of a dedicated operating space to perform the emergency orthopaedic surgeries without symptoms of COVID-19. Between March 23 and April 23, 2020, we have surgically treated 133 patients across both our hospitals in our trust. This mainly included hip fractures and fractures/infection affecting the hand.Aims
Methods
The adequate provision of personal protective equipment (PPE) for healthcare workers has come under considerable scrutiny during the COVID-19 pandemic. This study aimed to evaluate staff awareness of PPE guidance, perceptions of PPE measures, and concerns regarding PPE use while caring for COVID-19 patients. In addition, responses of doctors, nurses, and other healthcare professionals (OHCPs) were compared. The inclusion criteria were all staff working in clinical areas of the hospital. Staff were invited to take part using a link to an online questionnaire advertised by email, posters displayed in clinical areas, and social media. Questions grouped into the three key themes - staff awareness, perceptions, and concerns - were answered using a five-point Likert scale. The Kruskal-Wallis test was used to compare results across all three groups of staff.Aims
Methods
Peri-prosthetic joint infection is a serious and expensive complication of joint arthroplasty. Theatre discipline has infection prevention at its core with multiple studies correlating increased door opening with surgical site infection. The WHO, NICE and Philadelphia Consensus all advocate minimal theatre traffic. The Dutch Health Inspectorate consider >5 door openings per procedure excessive. This prospective observational study over five weeks observed theatre door traffic during hip and knee arthroplasty within the eight laminar flow theatres at our institution. Two students attached to the department collected data. Half way through the study notices reminding people not to enter during arthroplasty were placed on the theatre doors.Aim
Method
The majority of peri-prosthetic joint infection occurring within 1 year of surgery is due to introduction of microbes at the time of surgery. Lavage of total knee replacement leaves a pool of fluid on the surgical drapes. This fluid could be a direct source of wound contamination via suction catheter tip, gloves or instruments. Twenty patients undergoing total knee arthroplasty had a sample of drape fluid sent, after prosthesis implantation, for standard and enrichment culture. The surgery took place in a laminar low theatre with scrub teams in togasAim
Method
