Respiratory Virus Transmission during Orthopaedic Surgery in Low and Middle Income Countries: A Survey of Knowledge and Clinical Practices
Main Article Content
Abstract
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.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Chustecka Z. More Than 60 Doctors in Italy Have Died in COVID-19 Pandemic. Medscape 2020. [Available online: https://www.medscape.com/viewarticle/927753] Accessed March 10, 2023.
3. Giuffrida LT. As if a storm hit: more than 40 Italian health workers have died since crisis began. The Guardian 2020. [Available online at: https://www.theguardian.com/world/2020/mar/26/as-if-a-storm-hit-33-italian-health-workers-have-died-since-crisis-began] Accessed February 19, 2023.
4. Mencia MM, Goalan R. COVID-19 and its effects upon orthopaedic surgery: The Trinidad and Tobago experience. World J Orthop. 2021;12(3):94-101.
5. Chackan S, Islam S, Seepaul T, Harnarayan P, Naraynsingh V. COVID 19 And Its Impact On Orthopaedic Fracture Surgery And Traumatology In An Eastern Caribbean Island- A Retrospective Review ‘COVID 19 and Orthopaedic Surgery’. British J Med Health Sci. 2021;3:964-969.
6. Cawich SO, Harding HE, Crandon IW, et al. Leadership in Surgery for Public Sector Hospitals in Jamaica: Strategies for the Operating Room. Permanante Journal. 2013:17(3):12-17.
7. Nathan EK, Amekpor F, Scott GY, et al. Healthcare Workers' Safety; A Necessity for a Robust Health System. Ann Glob Health. 2023;89(1):57.
8. Cawich SO, Narayansingh G, Ramdass MJ, et al. Responses to disrupted operative care during the coronavirus pandemic at a Caribbean hospital. World J Met Anal 2022;10(3):74-80.
9. Hariharan S, Chen D. Costs and Utilization of Operating Rooms in a Public Hospital in Trinidad, West Indies. Perm J. 2015;19:128-132.
10. Cawich SO, Pooran S, Amow B, et al. Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean. Risk Manag Healthc Policy. 2016;9:253-260.
11. Valiee S, Zarei JZ, Kia M, et al. Strategies for maintaining and strengthening the health care workers during epidemics: a scoping review. Hum Resour Health. 2023;21(1):60.
12. Guo X, Wang J, Hu D, et al. Survey of COVID-19 Disease Among Orthopaedic Surgeons in Wuhan, People's Republic of China. J Bone Joint Surg Am. 2020;102(10):847-854.
13. Almohammed OA, Aldwihi LA, Alragas AM, Almoteer AI, Gopalakrishnan S, Alqahtani NM. Knowledge, Attitude, and Practices Associated With COVID-19 Among Healthcare Workers in Hospitals: A Cross-Sectional Study in Saudi Arabia. Front Public Health. 2021;9:643053
14. Harith AA, AbGani MH, Griffiths R, et al. Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia. Int J Environ Res Public Health. 2022;19(19):12485.
15. Nguyen LH, Drew DA, Graham MS, et al. Coronavirus Pandemic Epidemiology Consortium. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020;5(9):475-483.
16. Costantino C, Cannizzaro E, Verso MG, et al. SARS-CoV-2 Infection in Healthcare Professionals and General Population During "First Wave" of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy. Front Public Health. 2021;9:644008.
17. Oksanen LAH, Sanmark E, Oksanen SA, et al. Sources of healthcare workers' COVID‑19 infections and related safety guidelines. Int J Occup Med Environ Health. 2021;34(2):239-249.
18. Gordon CL, Trubiano JA, Holmes NE, et al. Staff to staff transmission as a driver of healthcare worker infections with COVID-19. Infect Dis Health. 2021;26(4):276-283.
19. Fillingham YA, Grosso MJ, Yates AJ, Austin MS. Personal Protective Equipment: Current Best Practices for Orthopaedic Teams. J Arthroplasty. 2020;35(7S):S19-S22.
20. Judson SD, Munster VJ. Nosocomial Transmission of Emerging Viruses via Aerosol-Generating Medical Procedures. Viruses. 2019;11(10):940.
21. Hirschmann MT, Hart A, Henckel J, Sadoghi P, Seil R, Mouton C. COVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon. Knee Surg Sports Traumatol Arthrosc. 2020;28(6):1690-1698.
22. Nogler M, Lass-Flörl C, Wimmer C, Bach C, Kaufmann C, Ogon M. Aerosols produced by high-speed cutters in cervical spine surgery: extent of environmental contamination. Eur Spine J. 2001;10(4):274-7.
23. Nogler M, Lass-Flörl C, Wimmer C, Mayr E, Bach C, Ogon M. Contamination during removal of cement in revision hip arthroplasty. A cadaver study using ultrasound and high-speed cutters. J Bone Joint Surg Br. 2003;85(3):436-9.
24. Public Health England: Guidance (2020) COVID-19 personal protective equipment (PPE). Updated 10 Apr 2020 (2020) [Available online at: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe] Accessed September 12, 2023.
25. World Health Organization, Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19): interim guidance, 19 March 2020. [Available online: https://www.who.int/publications/i/item/rational-use-of-personal-protective-equipment-(ppe)-for-coronavirus-disease-(covid-19)] Accessed August 15, 2023.
26. Alsofayan YM, Althunayyan SM, Khan AA, Hakawi AM, Assiri AM. Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study. J Infect Public Health. 2020;13(7):920-925.
27. Al-Tawfiq JA, Auwaerter PG. Healthcare-associated infections: the hallmark of Middle East respiratory syndrome coronavirus with review of the literature. J Hosp Infect. 2019;101(1):20-29.
28. Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, You G. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. J Hosp Infect. 2020;105(2):183-187.
29. Papagiannis D, Malli F, Raptis DG, et al. Assessment of Knowledge, Attitudes, and Practices towards New Coronavirus (SARS-CoV-2) of Health Care Professionals in Greece before the Outbreak Period. Int J Environ Res Public Health. 2020;17(14):4925.