Respiratory Virus Transmission during Orthopaedic Surgery in Low and Middle Income Countries: A Survey of Knowledge and Clinical Practices

Background: Orthopaedic surgeons, by virtue of the surgical tools they use, are very at high risk to contract respiratory viruses. This study sought to investigate orthopaedic surgeons’ knowledge, beliefs and practices on the use of personal protective equipment (PPE).

Methods: Using a self-administered survey, investigators collected data from orthopaedic surgeons in a middle-income nation. Data collection occurred over a two month period and statistical analyses were performed using SPSS version 20.0

Results: Data from 45 orthopaedic surgeons (70% response rate) were analysed. Although 73% of doctors had received some training on the use of PPE, 40% were dissatisfied because the information was ambiguous. Unfortunately, 18% of orthopaedic doctors did not recognise that power tools used during surgery generated virus-carrying aerosols and 36% erroneously believed that pulsatile lavage reduced the risk of viral transmission. Of all respondents, 78% were dissatisfied the PPE supplied by their hospitals, with the scarcity in the operating theatre achieving statistical significance. This prompted >75% of doctors to purchase PPE for their personal use in the public hospitals.

Conclusion: Our study uncovered beliefs and practices which are not supported by scientific evidence and may contribute to a higher risk of infection. Future research should prioritize infection control training that reflects the unique roles and responsibilities of different categories of staff within the healthcare system.