Efficacy of Dilute Betadine Solution Irrigation in the Prevention of Postoperative Infection of Spinal Surgery

Cheng, Ming; Chang, Ming Chau; Wang, Shih Tien; Yu, Wing Kwang; Liu, Chien Lin; Chen, Tain Hsiung

doi:10.1097/01.brs.0000171907.60775.85

Cited by 217 publications

(163 citation statements)

References 35 publications

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“…They use, in addition, jet lavage irrigation with detergent solution [31] before closure, with early results suggesting a much smaller infection rate. Another preventive measure was described by Cheng et al [32] in a prospective, randomised study. They found that irrigation of the spinal wound with dilute Betadine solution completely prevented infection in a group of 208 patients compared with a 2.9% rate in 206 patients who did not have Betadine irrigation.…”

Section: Preventionmentioning

confidence: 99%

Infections in spinal instrumentation

Gerometta

Olaverri

Bitan

2012

International Orthopaedics (SICOT)

126

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Surgical-site infection (SSI ) in the spine is a serious postoperative complication. Factors such as posterior surgical approach, arthrodesis, use of spinal instrumentation, age, obesity, diabetes, tobacco use, operating-room environment and estimated blood loss are well established in the literature to affect the risk of infection. Infection after spine surgery with instrumentation is becoming a common pathology. The reported infection rates range from 0.7% to 11.9%, depending on the diagnosis and complexity of the procedure. Besides operative factors, patient characteristics could also account for increased infection rates. These infections after instrumented spinal fusion are particularly difficult to manage due to the implanted, and possibly infected, instrumentation. Because the medical, economic and social costs of SSI after spinal instrumentation are enormous, any significant reduction in risks will pay dividends. The goal of this literature review was to analyse risk factors, causative organisms, diagnostic elements (both clinical and biological), different treatment options and their efficiency and consequences and the means of SSI prevention.

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Section: Preventionmentioning

confidence: 99%

Infections in spinal instrumentation

Gerometta

Olaverri

Bitan

2012

International Orthopaedics (SICOT)

126

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“…Very few literature are available for use of intraoperative irrigation of antiseptics or antimicrobial solution as a prophylaxis of post operative infection in spine surgery. 25,26 One patient had dural tear and required laminectomy for repair. Incidental dural tear has been reported in 3% case by Pearson AM et al 27 Resurgeries for recurrent herniation has been reported 4 to 48% in various series.…”

mentioning

confidence: 99%

Study of Clinical Variables Affecting Long Term Outcome after Microdisectomy for Lumbar Disc Herniation

Shrestha

Dhoju

et al. 2017

Kathmandu Univ. Med. J.

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“…A 10 % povidone-iodine solution was diluted to achieve a concentration of 3.5 % betadine, possessing maximal bactericidal activity and minimal cytotoxicity. No wound infection occurred in patients who received betadine irrigation during the follow-up period [26].…”

Section: Discussionmentioning

confidence: 99%

Extended indications of percutaneous endoscopic lavage and drainage for the treatment of lumbar infectious spondylitis

Yang

Chen

et al. 2014

Eur Spine J

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Purpose The treatment of spinal infection remains a challenge for spinal surgeons because of the variable presentations and complicated course. The diagnostic and therapeutic value of percutaneous endoscopic lavage and drainage (PELD) has been proved in some recent studies. The purpose of this study is to evaluate the efficacy of PELD in patients with advanced infectious spondylitis which may traditionally require open surgery. Methods We retrospectively reviewed the medical records of 21 patients who underwent PELD to treat their advanced lumbar infectious spondylitis. Patients with severe infection resulting in significant neurological deficit and mechanical instability were excluded from the PELD procedure, which was only used on selected patients with less severe disease. The 21 patients were categorized into three groups based on their past history, clinical presentation, and imaging studies: those with paraspinal abscesses, postoperative recurrent infection, and multilevel infection. Clinical outcomes were assessed by careful physical examination, Odom's criteria, regular serologic testing, and imaging studies to determine whether continued conservative treatment or surgical intervention was necessary. Results Causative bacteria were identified in 19 (90.5 %) of 21 biopsy specimens. Appropriate parenteral antibiotics for the predominant pathogen isolated from the infected tissue biopsy cultures were prescribed for the patients. All patients reported satisfactory recovery and relief of back pain, except three with multilevel infections who underwent anterior debridement and fusion within 2 weeks after treatment with PELD. The overall infection control rate was 86 %. One patient with epidural abscess and spondylolytic spondylolisthesis of the L5-S1 received instrumented fusion surgery due to mechanical instability 5 months later. No surgery-related major complications were found, except 2 patients who had transient paraesthesia in the affected lumbar segment. Conclusions PELD was successful in obtaining a bacteriologic diagnosis, relieving the patient's symptoms, and assisting in eradication of lumbar infectious spondylitis. The indications of this minimally invasive procedure could be extended to treat patients suffering from spinal infections with paraspinal abscesses and postoperative recurrent infection. Patients with multilevel infection may have trivial benefits from PELD due to poor infection control and mechanical instability of the affected segments.

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Efficacy of Dilute Betadine Solution Irrigation in the Prevention of Postoperative Infection of Spinal Surgery

Cited by 217 publications

References 35 publications

Infections in spinal instrumentation

Infections in spinal instrumentation

Study of Clinical Variables Affecting Long Term Outcome after Microdisectomy for Lumbar Disc Herniation

Extended indications of percutaneous endoscopic lavage and drainage for the treatment of lumbar infectious spondylitis

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