Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Kyoto, Japan.
Int Orthop. 2021 May;45(5):1147-1153. doi: 10.1007/s00264-021-04997-4. Epub 2021 Mar 2.
This study aimed to evaluate the acceptability of 14 days of self-quarantine and the positivity rate of pre-operative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) screening for patients undergoing elective orthopaedic surgery.
The self-quarantine programme and pre-operative SARS-CoV-2 PCR screening were initiated for patients who were scheduled for admission later than 7 May 2020 for elective orthopaedic surgery on admission. On the day of admission, the patients declared compliance with self-quarantine regulations. The admission was refused in cases of non-compliance. After admission, the patients underwent SARS-CoV-2 PCR screening. If PCR results were negative, isolation was terminated. If PCR results were positive, the surgery was postponed. If the patients had symptoms suspicious of coronavirus disease (COVID-19) after surgery, the PCR test was repeated.
Overall, 308 patients (age: 63.2 ± 18.8 years, 197 female and 111 male) were scheduled for elective orthopaedic surgery. Two patients did not agree with the requirements of self-quarantine, and two other procedures were cancelled. No non-compliance was reported; thus, the completion rate of the self-quarantine programme was 304/308 (98.7%). Finally, 304 patients underwent PCR testing, and there were no positive PCR results. After cancellations of four operations due to reasons other than COVID-19, 300 surgical procedures were performed. No patients developed COVID-19 during hospitalisation.
Although this system is based on trusting the good behaviour of patients, accompanied by PCR screening, we believe that the results showed the efficacy of the system in safely performing orthopaedic surgery during the COVID-19 pandemic.
本研究旨在评估 14 天自我隔离的可接受性，以及对择期骨科手术患者进行术前严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）聚合酶链反应（PCR）筛查的阳性率。
对于计划在 2020 年 5 月 7 日后入院接受择期骨科手术的患者，启动自我隔离计划和术前 SARS-CoV-2 PCR 筛查。入院当天，患者申报遵守自我隔离规定。不遵守规定者将被拒绝入院。入院后，患者接受 SARS-CoV-2 PCR 筛查。如果 PCR 结果为阴性，则解除隔离。如果 PCR 结果为阳性，则推迟手术。如果术后患者出现疑似冠状病毒病（COVID-19）的症状，则重复 PCR 检测。
总体而言，308 例患者（年龄：63.2±18.8 岁，197 例女性，111 例男性）拟行择期骨科手术。有 2 例患者不同意自我隔离的要求，另有 2 例手术被取消。无违规报告；因此，自我隔离计划的完成率为 304/308（98.7%）。最终，304 例患者接受了 PCR 检测，均未出现阳性 PCR 结果。由于 COVID-19 以外的原因取消了 4 例手术，共进行了 300 例手术。住院期间无患者发生 COVID-19。
尽管该系统基于对患者良好行为的信任，并辅以 PCR 筛查，但我们认为该系统在 COVID-19 大流行期间安全开展骨科手术的结果显示了该系统的有效性。
