Einfluss der FFP-2-Maske auf die postoperative Wundinfektionsrate nach einer onkologischen kolorektalen Resektion während der COVID-19-Pandemie
Im Rahmen der Covid-19-Pandemie seit dem Winter 2019/2020 kam es zu einer Verschärfung von Hygienestandards im Alltag und vor allem auch im Gesundheitssektor, um eine weitere Verbreitung des Virus zu verhindern. Einen Faktor dieser verschärften Hygienebestimmungen im Krankenhaus stellte das per...
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Format: | Doctoral Thesis |
Language: | German |
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Philipps-Universität Marburg
2022
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Online Access: | PDF Full Text |
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As of 2021, the COVID-19 pandemic led to raised hygiene standards both in everyday living and in the health sector in order to prevent further spread of the virus. Among these is the mandatory use of masks during patient care. In our institution, Johannes Wesling Klinikum in Minden, Germany, a mandatory use of face masks was imposed as of the beginning of 2021 aiming to reduce the spread of airborne droplet infections. The mainstay use of masks before the pandemic was during surgical procedures or interventions to prevent wound contamination and thus postoperative surgical site infections (SSI), although the evidence for this is inconclusive. Following this rationale, the question now arises whether wearing FFP-2 masks intra- and perioperatively could have an impact on the SSI rate compared to wearing standard surgical masks. To clarify this question, we designed a study in which data of patients having undergone an oncological operation in our institution between the beginning of 2016 and the end of 2021 was retrospectively gathered and evaluated. The primary endpoint was the development of a SSI and the secondary endpoints were further complications as well as hospital and intensive care unit length of stay. Two groups were formed: the first group consisting of patients having undergone treatment before the mandatory use of FFP-2 masks and the second consisting of patients treated during the mandatory use of FFP-2 masks. A total of 458 patients were included, 366 were assigned to the standard surgical mask group and 92 to the FFP-2 mask group. With overall good comparability of the groups, our evaluation revealed no significant differences in the SSI rate or other recorded data regarding the outcomes. Furthermore, a subgroup analysis in which patients with colon and rectal cancer were individually evaluated and compared, revealed no significant differences either. These groups were also comparable in terms of outcome. To date, there has been no study known to us examining the influence of FFP-2 masks on the SSI incidence specifically. However, studies examining the occurrence of SSI during the COVID-19 pandemic regardless of type of mask used have been conducted. These studies were able to demonstrate a significant decrease in the SSI rate since the outbreak of the pandemic, which was mainly explained by stricter adherence to hand hygiene and a reduction in hospital visits. In a regression analysis we searched for possible predictors for SSI occurrence in our patient collective, identifying the preoperative serum level of albumin as an independent predictor. There is also some evidence in the literature that low preoperative serum albumin is associated with significantly higher treatment costs. In summary, this study showed no influence of FFP-2 masks on the SSI rate in oncological resections of the colon or rectum. However, other studies indicate that the generally stricter hygiene regulations during the pandemic can lead to a decrease in SSI rate. In addition, this study was able to provide renewed evidence that the level of preoperative albumin has an influence on the SSI rate. To further support these claims, a prospective, randomized study would need to be conducted.