Letter: Comprehensive Neurosurgery Infection Prevention and Control Practice in the COVID-19 “Return to Operate” Era

Abstract

The COVID-19 pandemic has forced neurosurgeons to adapt in the face of an unforeseen crisis, including reevaluating an important aspect of neurosurgical practice: surgical infection control and prevention. Before COVID-19, surgical site infections (SSI) remained a costly and burdensome issue within neurosurgery and the medical field at-large. Furthermore, as options for linking payment to quality of care and mandatory reporting of SSI expands, cranial and spine surgery can expect to face increased oversight and pressure in efforts to reduce SSI. The risk of COVID-19 transmission to both patients and healthcare workers has inspired rigorous attention to inspection control practices. Therefore, at our institution we have applied the momentum gained introducing new infection control practices and procedures to prevent of COVID-19 transmission to the adoption of a surgical infection control bundle. We describe our implementation spanning screening and selection of patients for surgery, intraoperative precautions, postoperative care, and systems for monitoring and feedback.

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“…Choice of anesthetic drugs and the route of administration for these medications can have a significant impact on cerebral physiology during and after surgery and may influence clinical outcomes [53][54][55]. Administration of prophylactic antibiotics at induction, meticulous skin preparation and surgical technique can minimize risk of infection [56][57][58]. We advocate a systematic approach to the surgery, such that if an error occurs it can be traced back systematically, audited and corrected.…”