The risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of evidence has made it impossible for surgeons to give patients an informed perspective of the consequences of elective surgery in the presence of SARS-CoV-2. This study aims to determine, for the UK population, the probability of a patient being admitted with an undetected SARS-CoV-2 infection and their resulting risk of death; taking into consideration the current disease prevalence, reverse transcription-polymerase chain reaction (RT-PCR) testing, and preassessment pathway. The probability of SARS-CoV-2 infection with a false negative test was calculated using a lower-end RT-PCR sensitivity of 71%, specificity of 95%, and the UK disease prevalence of 0.24% reported in May 2020. Subsequently, a case fatality rate of 20.5% was applied as a worst-case scenario.Aims
Methods
Diabetes mellitus is the most common co-morbidity associated
with necrotising fasciitis. This study aims to compare the clinical
presentation, investigations, Laboratory Risk Indicator for Necrotising
Fasciitis (LRINEC) score, microbiology and outcome of management
of this condition in diabetic and non-diabetic patients. The medical records of all patients with surgically proven necrotising
fasciitis treated at our institution between 2005 and 2014 were
reviewed. Diagnosis of necrotising fasciitis was made on findings
of ‘dishwater’ fluid, presence of greyish necrotic deep fascia and
lack of bleeding on muscle dissection found intra-operatively. Information
on patients’ demographics, presenting symptoms, clinical signs,
investigations, treatment and outcome were recorded and analysed.Aims
Patients and Methods