Postoperative Spine Infections: Prevention and Treatment

Bible, Jesse E.; Donaldson, William F.

doi:10.1053/j.oto.2015.12.002

Cited by 6 publications

(12 citation statements)

References 50 publications

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“…Only 6 patients developed SSIs among ICRP group. We also found 8 patients in ICRP group represented secondary infections such as urinary tract infection10, atelectasis6, pseudomembranous colitis3, deep vein thrombosis3, and pneumonia3. However, no signs of infection were detected in the other 29 patients.…”

Section: Resultsmentioning

confidence: 66%

“…Twenty-six patients in DCRP group showed a secondary elevation on POD14 and 5 of 26 patients developed SSI. Five patients were also found to carry secondary infections such as urinary tract infection3, atelectasis3, pseudomembranous colitis3, pulmonary embolism3, and pneumonia3. However, the remaining patients showing secondary elevation revealed no causes of infection.…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of SSI is relatively frequent, and is reported to range from 0.7% to 11%1,2. SSI requires long-term antibiotic therapy, prolonged hospital stay, and surgical debridement or revision surgery3,4. Nevertheless, the diagnosis of SSI is a clinical challenge, and is difficult to distinguish from the normal postoperative course.…”

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confidence: 99%

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A reliable diagnostic method of surgical site infection after posterior lumbar surgery based on serial C-reactive protein

Kim

Park

Kim

2021

International Journal of Surgery: Global Health

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Study design: A observational study. Purpose: To evaluate the detection of surgical site infection (SSI) after posterior lumbar surgery by the laboratory parameters. Materials and methods: The study included 189 patients undergoing posterior lumbar fusion or decompression between January 2018 and December 2019. Patients with chronic renal disease, rheumatoid arthritis, hepatic disease were excluded. Patients with tumor, trauma, cervical and thoracic lesions were also excluded. Leukocyte counts, segmented neutrophils, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were evaluated preoperatively and on postoperative days 1 (POD1), 3 (POD3), 7 (POD7), 14 (POD14), and 30 (POD30). Surgical site infection was defined as (1) purulent discharge at incision site, (2) organisms isolated aseptically from the incision site, and (3) evidence of infection based on MRI. Increasing CRP (ICRP) and decreasing CRP (DCRP) groups were classified according to the value of CRP on POD7. The change rate in CRP was calculated using the formula: (Late value−Previous value/Previous value)×100. Receiver operating characteristic curves were used to validate laboratory data involving SSI. Results: The mean age was 64.5±12.5 years. Male to female ratio was 91–98. The incidence of SSI was 8.8%. Leukocyte count, segmented neutrophil, and ESR were not specific. ICRP group were 43 patients. SSI was found in 14% of ICRP group and 18.6% was associated with secondary infection. Even 7.7% of the infection in DCRP group was identified as SSI. Based on the change rate of CRP, −50% of decreasing rate of CRP in ICRP group between POD7 and POD14 showed the validity that sensitivity was 90.9% and specificity was 68.1%. In DCRP group, −43.3% of decreasing rate of CRP in DCRP group between POD7 and POD14 showed the validity that sensitivity and specificity were 83.3% and 82.4%, respectively. Only 43% of all patients showed normalization of CRP can rule out the SSI. Conclusion: The serial change rate of CRP is a reliable method for detecting SSI more than the criteria of normal value. Nevertheless, close monitoring of patient’s signs and symptoms is important to detect early SSI.

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Section: Resultsmentioning

confidence: 66%

Section: Resultsmentioning

confidence: 99%

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A reliable diagnostic method of surgical site infection after posterior lumbar surgery based on serial C-reactive protein

Kim

Park

Kim

2021

International Journal of Surgery: Global Health

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“…Surgical site infections (SSIs) is one of the most common postoperative complications 3,4 . In prior research, about one‐quarter of the patients who had undergone spine operations had SSIs after the operation 5,6 . Not only does this result in poor outcomes, but it also raises healthcare costs 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Effect of drain placement in short‐level spinal surgery on postoperative wound infection: A meta‐analysis

Zhan,

Fang,

et al. 2023

International Wound Journal

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In the meta‐analysis, we evaluated the efficacy of placing drainage channels following single‐ or double‐level spine surgery in order to decrease the incidence of postoperative injury. We conducted the analysis with the help of four databases: PubMed, Embase, Cochrane Library and Web of Science. A review of related studies was carried out after evaluating the quality of the literature against the classification and exclusion criteria set for the trial. Calculation of 95% CI, OR and MD was performed with fixed‐effect models. A meta‐analysis of the data was carried out with RevMan 5.3. Meta‐analyses of randomized controlled trial (RCT) did not indicate that there were a statistically significantly different incidence of postoperative wound infections among those who received drainage compared to those who did not receive drainage (OR, 2.29; 95% CI, 0.50, 10.41 p = 0.28). Moreover, there were no statistically significant differences in post‐operation hematoma (OR, 1.20; 95% CI, 0.27, 5.28 p = 0.81) and visual analogue scale score (MD, −0.01; 95% CI, −1.34, 1.33 p = 0.99). Thus, placing drainage in short‐levels of spine operation did not significantly influence the outcome of postoperative wound complications. Nevertheless, because of the limited sample size chosen for this meta‐analysis, caution should be exercised when treating these data. More high‐quality RCT trials with a large number of samples are required to confirm the findings.

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“…Wound dehiscence was also among the most common complications in spinal fusion surgeries [6] . Infection places the patient at high risk for pseudoarthrosis, chronic pain, return to the operating room, adverse neurological sequelae, worsened long-term outcomes, and even death [7] , [8] , [9] , [10] , [11] , [12] . However, prompt diagnosis and aggressive treatment can lead to successful outcomes [7] .…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of postoperative spinal wound infection in the Middle East and North Africa (MENA) region

Abolfotouh

Khattab

Zaman

et al. 2023

North American Spine Society Journal (NASSJ)

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Postoperative Spine Infections: Prevention and Treatment

Cited by 6 publications

References 50 publications

A reliable diagnostic method of surgical site infection after posterior lumbar surgery based on serial C-reactive protein

A reliable diagnostic method of surgical site infection after posterior lumbar surgery based on serial C-reactive protein

Effect of drain placement in short‐level spinal surgery on postoperative wound infection: A meta‐analysis

Epidemiology of postoperative spinal wound infection in the Middle East and North Africa (MENA) region

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