Postoperative Wound Infections Complicating Adult Spine Surgery

1992 ◽  
Vol 5 (3) ◽  
pp. 277-285 ◽  
Author(s):  
Jeffery L. Stambough ◽  
Donald Beringer
Keyword(s):  
Spine Surgery ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Adult Spine

Management of Deep Spinal Wound Infections Following Instrumentation Surgery with Subfascial Negative Pressure Wound Therapy

2021 ◽  
Author(s):  
Marcus Rickert ◽  
Michael Rauschmann ◽  
Nizar Latif-Richter ◽  
Mohammad Arabmotlagh ◽  
Tamin Rahim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Wound Infection ◽  
Spinal Fusion ◽  
Negative Pressure Wound Therapy ◽  
Wound Infections ◽  
Wound Therapy ◽  
Postoperative Wound ◽  
Deep Wound ◽  
The Impact

Abstract Background and Study Aims The treatment of infections following a spine surgery continues to be a challenge. Negative pressure wound therapy (NPWT) has been an effective method in the context of infection therapy, and its use has gained popularity in recent decades. This study aims to analyze the impact of known risk factors for postoperative wound infection on the efficiency and length of NPWT therapy until healing. Patients and Methods We analyzed 50 cases of NPWT treatment for deep wound infection after posterior and posteroanterior spinal fusion from March 2010 to July 2014 retrospectively. We included 32 women and 18 men with a mean age of 69 years (range, 36–87 years). Individual risk factors for postoperative infection, such as age, gender, obesity, diabetes, immunosuppression, duration of surgery, intraoperative blood loss, and previous surgeries, as well as type and onset (early vs. late) of the infection were analyzed. We assessed the associations between these risk factors and the number of revisions until wound healing. Results In 42 patients (84%), bacterial pathogens were successfully detected by means of intraoperative swabs and tissue samples during first revision. A total of 19 different pathogens could be identified with a preponderance of Staphylococcus epidermidis (21.4%) and S. aureus (19.0%). Methicillin-resistant S. aureus (MRSA) was recorded in two patients (2.6%). An average of four NPWT revisions was required until the infection was cured. Patients with infections caused by mixed pathogens required a significantly higher number of revisions (5.3 vs. 3.3; p < 0.01) until definitive wound healing. For the risk factors, no significant differences in the number of revisions could be demonstrated when compared with the patients without the respective risk factor. Conclusion NPWT was an effective therapy for the treatment of wound infections after spinal fusion. All patients in the study had their infections successfully cured, and all spinal implants could be retained. The number of revisions was similar to those reported in the published literature. The present study provides insights regarding the effectiveness of NPWT for the treatment of deep wound infection after spinal fusion. Further investigations on the impact of potential risk factors for postoperative wound healing disorders are required. Better knowledge on the impact of specific risk factors will contribute to a higher effectiveness of prophylaxis for postoperative wound infections considering the patient-specific situation.

Group C Streptococcal Surgical Wound Infections Transmitted by an Anorectal and Nasal Carrier

PEDIATRICS ◽  
1978 ◽  
Vol 61 (2) ◽  
pp. 235-237
Author(s):  
Donald A. Goldmann ◽  
Sylvia J. Breton
Keyword(s):  
Postoperative Infection ◽  
Wound Infections ◽  
Surgical Wound ◽  
Postoperative Wound ◽  
Nasal Carrier ◽  
Surgical Infection ◽  
Oral Penicillin ◽  
Perianal Dermatitis ◽  
Lancefield Group

Streptococcus equisimilis (Lancefield group C), an unusual cause of nosocomial surgical infection, was isolated from two orthopedic postoperative wound infections. Both operations had been performed by the same surgeon within a three-day period. Examination of the surgeon revealed perianal dermatitis from which S. equisimilis was isolated. The organism was also recovered from the surgeon's nose and rectum. The wound infections responded to treatment with penicillin derivatives. The surgeon was successfully treated with topical bacitracin and oral penicillin and vancomycin. This report documents the pathogenicity of the C Streptococcus in postoperative infection and suggests a possible nosocomial source of the organism.

scholarly journals POST OPERATIVE WOUND INFECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
SUHAIL AMER
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Prophylactic Antibiotics ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Lichtenstein Hernia Repair ◽  
Significant Difference

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad. Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repairelectively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results were assessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections in both groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.

scholarly journals A longitudinal survey of adult spine and peripheral nerve case entries during neurosurgery residency training

2018 ◽  
Vol 29 (4) ◽  
pp. 442-447 ◽  
Author(s):  
Nitin Agarwal ◽  
Michael D. White ◽  
D. Kojo Hamilton
Keyword(s):  
Peripheral Nerve ◽  
Residency Training ◽  
Spine Surgery ◽  
Linear Regression Analysis ◽  
Critical Role ◽  
Senior Resident ◽  
Case Volume ◽  
Minimum Requirements ◽  
The Mean ◽  
Adult Spine

OBJECTIVECurrently, there is a lack of research assessing residents’ operative experience and caseload variability. The current study utilizes data from the Accreditation Council for Graduate Medical Education (ACGME) case log system to analyze national trends in neurosurgical residents’ exposure to adult spinal procedures.METHODSProspectively populated ACGME resident case logs from 2013 to 2017 were retrospectively reviewed. The reported number of spinal procedures was compared to the ACGME minimum requirements for each surgical category pertaining to adult spine surgery. A linear regression analysis was conducted to identify changes in operative caseload by residents graduating during the study period, as well as a one-sample t-test using IBM SPSS software to compare the mean number of procedures in each surgical category to the ACGME required minimums.RESULTSA mean of 427.42 total spinal procedures were performed throughout residency training for each of the 877 residents graduating between 2013 and 2017. The mean number of procedures completed by graduating residents increased by 19.96 (r2 = 0.95) cases per year. The number of cases in every procedural subspecialty, besides peripheral nerve operations, significantly increased during this time. The two procedural categories with the largest changes were anterior and posterior cervical approaches for decompression/stabilization, which increased by 8.78% per year (r2 = 0.95) and 9.04% per year (r2 = 0.95), respectively. There was also a trend of increasing cases logged for lead resident surgeons and a decline in cases logged for senior resident surgeons. Residents’ mean caseloads during residency were found to be vastly greater than the ACGME required minimums: residents performed at least twice as many procedures as the required minimums in every surgical category.CONCLUSIONSGraduating neurosurgical residents reported increasing case volumes for adult spinal cases during this 5-year interval. An increase in logged cases for lead resident surgeons as opposed to senior resident surgeons indicates that residents were logging more cases in which they had a more critical role in the procedure. Moreover, the average resident was noted to perform more than twice the number of procedures required by the ACGME in every surgical category, indicating that neurosurgical residents are getting greater exposure to spine surgery than expected. Given the known correlation between case volume and improved surgical outcomes, this data demonstrates each graduating neurosurgical residency class experiences an augmented training in spine surgery.

Clean/Dirty Scrub Technique: Is it Worth the Effort?

2001 ◽  
Vol 11 (12) ◽  
pp. 532-537
Author(s):  
Marilyn Williams ◽  
Elizabeth Bruen
Keyword(s):  
Literature Review ◽  
Surgical Procedure ◽  
Vital Role ◽  
Wound Infections ◽  
Aseptic Technique ◽  
Surgical Practice ◽  
Postoperative Wound ◽  
Bowel Surgery ◽  
Do So

Asepsis is a vital underlying practice for any surgical procedure and it is part of every perioperative nurse's responsibility to participate actively in incorporating the principles of aseptic technique into surgical practice. Not to do so exposes the patient to a risk that could have been avoided. The following literature review of the practice of clean and dirty technique in bowel surgery indicates that it may play a vital role in the prevention of postoperative wound infections.

Sign in / Sign up

Export Citation Format

Share Document