CURRENT STRATEGIES IN THE PREVENTION OF POSTOPERATIVE INFECTIONS IN SPINAL SURGERY

Authors

  • KU REHMAM Department of Spine Surgery, Hayatabad Medical Complex Peshawar Khyber Pakhtunkhwa, Pakistan
  • A ALI Department of Spine Surgery, Hayatabad Medical Complex Peshawar Khyber Pakhtunkhwa, Pakistan
  • A SATTAR Department of Spine Surgery, Hayatabad Medical Complex Peshawar Khyber Pakhtunkhwa, Pakistan
  • SK KHAN Department of Spine Surgery, Hayatabad Medical Complex Peshawar Khyber Pakhtunkhwa, Pakistan
  • MZ KHAN Department of Spine Surgery, Hayatabad Medical Complex Peshawar Khyber Pakhtunkhwa, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.488

Keywords:

Spinal surgery, postoperative infections, prevention, wound irrigation.

Abstract

This study aimed to analyze the strategies used to prevent postoperative infections in spinal surgery and evaluate their effectiveness in reducing the frequency of infections. The study design was retrospective and was conducted between January and December 2021 at the Department of Orthopedic & Spine Surgery, Hayatabad Medical Complex. The study included a total of 90 patients who were divided into two groups based on the preventative techniques used. Group A (n=45) received standard preventive measures, such as preoperative antibiotics, accurate aseptic techniques, and postoperative wound care. In comparison, Group B (n=45) was given supplementary preventive measures such as antibiotic-impregnated bone grafts and wound irrigation with antiseptic solutions. The occurrence of postoperative infections, namely surgical site infections (SSIs) and deep wound infections, was documented and compared between the two groups. The mean age of patients in Group A was 55.2±8.6 years, while it was 57.8±9.2 years in Group B. Group A consisted of 27 (60%) male and 18 (40%) female patients, whereas Group B had 29 (64.44%) male and 16 (35.55%) female patients. Nine (20%) patients in Group A developed postoperative infections, while only three (6.7%) in Group B developed infections. The difference in postoperative infection incidence between the two groups was statistically significant (p<0.05). Similarly, the incidence of SSIs was lower in Group B (4.4%) than in Group A (15.6%) (p<0.05). Most patients in both groups (55.55% in Group A and 48.88% in Group B) received lumbar fusion surgery. Cervical fusion surgery was performed on 10 (22.22%) Group A patients and 12 (26.66%) Group B patients. Decompression surgery was performed on eight (17.77%) patients in Group A and nine (20%) individuals in Group B. The study's findings indicate that preventive techniques, such as antibiotic-impregnated bone grafts and wound irrigation with antiseptic solutions, can significantly reduce postoperative infections in spine surgery. However, further research is needed to determine the long-term effectiveness of these prevention approaches and explore alternative methods for preventing postoperative infections in spine surgery.

Downloads

Download data is not yet available.

References

Anderson, D. J., Podgorny, K., Berríos-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., Nyquist, A.-C., Saiman, L., Yokoe, D. S., and Maragakis, L. L. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology 35, S66-S88.

Bigliardi, P. L., Alsagoff, S. A. L., El-Kafrawi, H. Y., Pyon, J.-K., Wa, C. T. C., and Villa, M. A. (2017). Povidone iodine in wound healing: A review of current concepts and practices. International Journal of Surgery 44, 260-268.

Brüggmann, D., Tchartchian, G., Wallwiener, M., Münstedt, K., Tinneberg, H.-R., and Hackethal, A. (2010). Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options. Deutsches ärzteblatt international 107, 769.

Chou, P.-H., Lin, H.-H., Yao, Y.-C., Chang, M.-C., Liu, C.-L., and Wang, S.-T. (2022). Does local vancomycin powder impregnated with autogenous bone graft and bone substitute decrease the risk of deep surgical site infection in degenerative lumbar spine fusion surgery?—An ambispective study. BMC Musculoskeletal Disorders 23, 853.

Daniell, J. R., and Osti, O. L. (2018). Failed back surgery syndrome: a review article. Asian spine journal 12, 372.

Deer, T., Sayed, D., Michels, J., Josephson, Y., Li, S., and Calodney, A. K. (2019). A review of lumbar spinal stenosis with intermittent neurogenic claudication: disease and diagnosis. Pain medicine 20, S32-S44.

Ding, S., Lin, F., Marshall, A. P., and Gillespie, B. M. (2017). Nurses' practice in preventing postoperative wound infections: an observational study. Journal of wound care 26, 28-37.

Follett, K. A., and Dirks, B. A. (1993). Etiology and evaluation of the failed back surgery syndrome. Neurosurgery quarterly 3, 40.

Gerszten, P. C., Paschel, E., Grandhi, R., Okonkwo, D., Kanter, A., Chang, Y.-F., Kushkuley, J., Feroze, A., Choudhri, O., and Skukalek, S. L. (2015). 860. Outcome of Mechanical Thrombectomy in the Elderly for the Treatment of Acute Ischemic Stroke. Journal of Neurosurgery 123, A479-A541.

Hodgkiss-Harlow, K. D., and Bandyk, D. F. (2011). Antibiotic therapy of aortic graft infection: treatment and prevention recommendations. In "Seminars in vascular surgery", Vol. 24, pp. 191-198. Elsevier.

Kallala, R., Graham, S. M., Nikkhah, D., Kyrkos, M., Heliotis, M., Mantalaris, A., and Tsiridis, E. (2012). In vitro and in vivo effects of antibiotics on bone cell metabolism and fracture healing. Expert Opinion on Drug Safety 11, 15-32.

Litany, R. J., and Praseetha, P. (2022). Tiny tots for a big-league in wound repair: Tools for tissue regeneration by nanotechniques of today. Journal of Controlled Release 349, 443-459.

Zalavras, C. G., and Patzakis, M. J. (2003). Open fractures: evaluation and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons 11, 212-219.

Zamborsky, R., Svec, A., Bohac, M., Kilian, M., and Kokavec, M. (2016). Infection in bone allograft transplants. Exp Clin Transplant 14, 484-490.

Zhao, L., Zhang, W., Liu, K., Chen, X., Yang, K., Chen, X., and Hu, J. (2023). Comparing the efficacy of povidone-iodine and normal saline in incisional wound irrigation to prevent superficial surgical site infection: a randomized clinical trial in gastric surgery. Journal of Hospital Infection 131, 99-106.

Zhao, Z., Wang, G., Zhang, Y., Luo, W., Liu, S., Zeng, Z., Liu, Y., Zhou, Y., and Zhang, Y. (2020). Induced membrane technique combined with antibiotic-loaded calcium sulfate–calcium phosphate composite as bone graft expander for the treatment of large infected bone defects: preliminary results of 12 cases. Annals of Translational Medicine 8.

Downloads

Published

2023-10-25

How to Cite

REHMAM , K., ALI , A., SATTAR , A., KHAN , S., & KHAN , M. (2023). CURRENT STRATEGIES IN THE PREVENTION OF POSTOPERATIVE INFECTIONS IN SPINAL SURGERY. Biological and Clinical Sciences Research Journal, 2023(1), 488. https://doi.org/10.54112/bcsrj.v2023i1.488

Most read articles by the same author(s)

<< < 1 2 3 4 > >>