scholarly journals An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery

2016 ◽  
Vol 98 (5) ◽  
pp. 320-323 ◽  
Author(s):  
B van Herwijnen ◽  
NR Evans ◽  
CJ Dare ◽  
EM Davies
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Surgical Site Infection ◽  
Povidone Iodine ◽  
High Risk Patient ◽  
Scoliosis Surgery ◽  
Site Infection ◽  
Scoliosis Correction ◽  
Vancomycin Powder ◽  
Baseline Characteristics

Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients’ baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups.

Surgical Site Infection in Adolescent Idiopathic Scoliosis Surgery

2013 ◽  
Vol 1 (5) ◽  
pp. 352-358 ◽  
Author(s):  
Michelle C. Marks ◽  
Peter O. Newton ◽  
Tracey P. Bastrom ◽  
Randal R. Betz ◽  
Paul D. Sponseller ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Surgical Site Infection ◽  
Scoliosis Surgery ◽  
Site Infection

Does Staphylococcus aureus nasal decontamination affect the rate of early surgical site infection in adolescent idiopathic scoliosis surgery?

2018 ◽  
Vol 27 (10) ◽  
pp. 2543-2549 ◽  
Author(s):  
Cindy Mallet ◽  
Marion Caseris ◽  
Catherine Doit ◽  
Anne-Laure Simon ◽  
Daphné Michelet ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Surgical Site Infection ◽  
Scoliosis Surgery ◽  
Site Infection

11. Prophylactic use of local vancomycin does not decrease acute surgical site infection in adolescent idiopathic scoliosis

2021 ◽  
Vol 21 (9) ◽  
pp. S6
Author(s):  
Stephen Stephan ◽  
De-An Zhang ◽  
Marilan Luong ◽  
Robert Cho ◽  
Selina Poon
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Prophylactic Use

scholarly journals Intraoperative Computed Tomography versus Perdriolle and Scoliometer Evaluation of Spine Rotation in Adolescent Idiopathic Scoliosis

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Rafal Pankowski ◽  
Szymon Wałejko ◽  
Marek Rocławski ◽  
Marcin Ceynowa ◽  
Tomasz Mazurek
Keyword(s):  
Computed Tomography ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Scoliosis Surgery ◽  
Significant Discrepancy ◽  
Indirect Methods ◽  
Rib Hump ◽  
Intraoperative Computed Tomography ◽  
Scoliosis Correction ◽  
Before And After

Numerous indirect methods for apical vertebral rotation (AVR) measurement have been reported and none of them seems to be as accurate as computed tomography evaluation. The aim of this study was to compare spinal rotation changes during innovative technique of intraoperative computed tomography (ICT) evaluation with indirect methods such as Perdriolle and clinical evaluation with scoliometer. We examined 42 adolescent idiopathic scoliosis (AIS) patients treated with posterior scoliosis surgery (PSS). The mean age at the time of surgery was 16 years. ICT evaluation was performed before and after scoliosis correction in prone position. Clinical rib hump measure with scoliometer and radiographic Perdriolle were performed before and after surgery. There was 71,5% of average rib hump correction with scoliometer but only 31% of correction with ICT (P=0,026) and there was no significant correlation between them (R=0,297,p=0,26). Mean postcorrectional Perdriolle AVR had a decrease of 16,5°. The average ICT AVR had a decrease of only 1,2° (P=0,003). There was no significant statistic correlation between ICT and Perdriolle AVR evaluation (R=0,297,p=0,2). There is a significant discrepancy in AVR and rib hump assessment between scoliometer and Perdriolle methods and ICT evaluation, which seems to be the most accurate tool for spinal derotation measurement.

scholarly journals Povidone-iodine irrigation combined with Vancomycin powder lowers infection rates in pediatric deformity surgery

2021 ◽  
Author(s):  
Rolando Figueroa Roberto ◽  
Flynn Andrew Rowan ◽  
Deepak Nallur ◽  
Blythe Durbin-Johnson ◽  
Yashar Javidan ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Povidone Iodine ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Small Sample ◽  
Site Infection ◽  
Infection Rates ◽  
Vancomycin Powder

Abstract Background Surgical site infection is a morbid, devastating complication after spinal procedures. Studies have investigated the effect of wound lavage with 3.5% Povidone-iodine solution or the use of intrawound Vancomycin powder. We examined the effect of Povidone-iodine irrigation, intrawound Vancomycin powder, or a combination of both agents in a tertiary care Pediatric Hospital. Methods We queried our health system database for patients undergoing spinal surgery over an eight-year span between January 2008 and June 2016 and identified patient cohorts who received no intervention, intrawound Vancomycin alone, Povidone-iodine irrigation alone, or a combination of both agents. Infection rates were determined. The effect of treatment on outcome was analyzed using a logistic regression model. Results 475 patients were identified who met study inclusion criteria. 88 non-neuromuscular patients received no intra-operative agent. The surgical site infection (SSI) rate in this group of patients was 10%. For the 194 non-neuromuscular scoliosis patients who received Povidone-iodine and Vancomycin powder, the infection rate was reduced to 0.7%. The SSI rate in the 180 non-neuromuscular patients who were treated with Vancomycin powder alone was 1.4%. 13 patients were treated with Povidone-iodine lavage only, with a small sample size precluding statistical comparison. Infection rate in the 132 neuromuscular disease patients decreased from 14 to 7% overall during this time span: while the odds ratio of infection was reduced in all neuromuscular treatment groups receiving intra-operative measures, statistical significance was not reached in any neuromuscular group studied. Conclusions A protocol using combined 3.5% weight/volume Povidone-iodine and Vancomycin powder was associated with the lowest infection rate in our non-neuromuscular patient population and should be considered as a low cost intervention in pediatric patients undergoing spinal deformity procedures. Level of evidence Level II.

scholarly journals Does Posterior Scoliosis Correction Improve Respiratory Function in Adolescent Idiopathic Scoliosis? A Systematic Review and Meta-analysis

2018 ◽  
Vol 9 (8) ◽  
pp. 866-873
Author(s):  
So Kato ◽  
Jean-Christophe Murray ◽  
Mario Ganau ◽  
Yongyao Tan ◽  
Yasushi Oshima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Respiratory Function ◽  
Meta Analysis ◽  
Scoliosis Surgery ◽  
Scoliosis Correction ◽  
Predicted Values

Study Design: A systematic review and meta-analysis. Objectives: Pulmonary dysfunction is often advocated among the indications for surgical correction of adolescent idiopathic scoliosis (AIS). Previous studies have discussed the effect of scoliosis correction on respiratory function without reaching a definitive conclusion: Some showed that the respiratory function can improve after scoliosis surgery without defining the precise role of anterior, posterior, and combined approaches on this improvement; furthermore, the majority of these studies did not take normal growth into account. As a result, the role of surgery remains to be clarified. The object of the present study was to synthesize the current knowledge regarding changes in respiratory function after posterior corrective surgery for AIS. Methods: A comprehensive systematic search was performed to identify all relevant studies in the following electronic databases: MEDLINE, EMBASE, CINAHL (EBSCO). We focused on the studies (1) that discussed posterior fusion surgery for AIS without thoracoplasty, (2) that discussed comparisons of pre- and postoperative percent-predicted values of forced vital capacity (%FVC) or forced expiratory volume (%FEV), and (3) with minimum 2-year follow-up. Forest plots were depicted and Z value was calculated as a test for overall effect. Results: Ten studies (6 prospective and 4 retrospective studies) met our inclusion criteria. The overall effect showed that there was no significant difference in %FVC or %FEV between pre- and postoperative measurements (very low evidence). Conclusions: Posterior correction surgery for mild to moderate AIS patients showed no significant improvement of postoperative respiratory function measured by relative, percent-predicted values at minimum 2-year follow-up.

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