Surgical Site Infection after Cesarean Delivery in Times of COVID-19

Abstract

Objective To analyze effects of the COVID-19 pandemic on the consumption of personal protective equipment and products (PPEP), as well as the frequency of surgical site infection (SSI) among non-COVID-19 patients submitted to cesarean sections. Methods A retrospective study was conducted in a maternity unity of a public teaching hospital which was not part of the reference service for COVID-19 treatment. It compared PPEP consumption and the occurrence of SSI after cesarean sections in monthly periods before and after the occurrence of the first case of COVID-19 in Porto Alegre, state of Rio Grande do Sul, Brazil. Personal protective equipment and products consumption was measured as units of masks, gloves, gowns, and caps, and use of alcohol-based products or soap for hand sanitation as ml/patient/day. The SSI index was calculated as the proportion of cases of SSI over the number of cesarean sections performed monthly during the study period. Results There was an increase in all measured items of PPEP, with consumption of disposable masks with a median of 1,450 units in the pre-COVID period, and of 2550 in the post-COVID period (a 75.9% increase). A decrease of 49% in SSI was detected, with a median of 1.74 in the pre-COVID period and of 0.89 in the post-COVID period. Conclusion The increase in consumption of PPEP could be a result of safer practices adopted by healthcare workers with the advent of COVID-19, of which the following reduction in the occurrence of SSI could be a direct consequence. Despite the severity of the crisis, one could state that extreme situations can lead to valuable reflections and opportunities for improvement.

Surgical site infections in patients undergoing breast oncological surgery during the lockdown: An unexpected lesson from the COVID-19 pandemic

“…The overall SSIs rate observed in this series was 9.1% according to CDC criteria and 6.5% according to ASEPSIS criteria, which is in line with the range reported in the literature (from 0.8% to 26%) [ 14 – 19 , 24 ]. As expected, and as reported in literature [ 25 – 29 ], the SSIs rate observed in this study decreased during the pandemic period. Moreover, the SSIs rate according to ASEPSIS criteria was statistically lower in the PC than in the CC ( P < 0.0001).…”

A retrospective cohort study of the impact of COVID‐19 infection control measures on surgical site infections in an academic hospital setting

“…In their study, median SSI was 1.74 in the pre-COVID period while it was 0.89 in the post-COVID period. 13 In a study from Germany, Chac on-Quesada and colleagues report that post-neurosurgery SSI rate was 2.9% before COVID-19 began and after COVID-19 hygiene measures, this rate dropped to 1.4% resembling a significant reduction (p = 0.003). 18 Ishibashi et al report from gastrointestinal surgeries performed in Japan that superficial SSI and infectious colitis occurred less frequently during the pandemic (p = 0.04 and p = 0.0002, respectively).…”

“…Despite the severity of the crisis, the COVID‐19 pandemic had a positive effect on safety measures and infection control, and the extremeness of the pandemic may lead to valuable reflections, insights, and opportunities for improvement 13 . The aim of this study is to analyse the possible association of the COVID‐19 epidemic‐related increased health measures, such as PPE consumption increased hand hygiene and restrictions imposed, on the frequency of SSIs in an academic medical centre.…”

The Management of Urinary Tract Infections during the COVID-19 Pandemic: What Do We Need to Know?

“…Recently, Antonello Vs et al demonstrated a significant decrease (49%) in surgical site infection during the COVID-19 pandemic in comparison with a pre-COVID period. The authors highlight the importance of increased use of personal protective equipment and products in the operating theater [27].…”