scholarly journals Experience with intrawound vancomycin powder for posterior cervical fusion surgery

2015 ◽  
Vol 22 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Joel R. Martin ◽  
Owoicho Adogwa ◽  
Christopher R. Brown ◽  
Maragatha Kuchibhatla ◽  
Carlos A. Bagley ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Wound Infection ◽  
Site Infection ◽  
Cervical Fusion ◽  
Fusion Surgery ◽  
Deep Wound Infection ◽  
Deep Wound ◽  
Vancomycin Powder ◽  
Posterior Cervical Fusion ◽  
Propensity Score Adjustment

OBJECT Recent studies have reported that the local delivery of vancomycin powder is associated with a decrease in spinal surgical site infection. This retrospective cohort study compares posterior cervical fusion cases before and after the routine application of spinal vancomycin powder to evaluate the ability of local vancomycin powder to prevent deep wound infection after posterior cervical spinal fusion. METHODS Posterior cervical fusion spinal surgeries performed at a single institution were reviewed from January 2011 to July 2013. Each cohort's baseline characteristics, operative data, and rates of wound infection were compared. Associations between infection and vancomycin powder, with and without propensity score adjustment for risk factors, were determined using logistic regression. RESULTS A total of 289 patients (174 untreated and 115 treated with vancomycin powder) were included in the study. The cohorts were similar in terms of baseline and operative variables. No significant change in deep wound infection rate was seen between the control group (6.9%) and intervention group (5.2%, p = 0.563). Logistic regression, with and without propensity score adjustment, demonstrated that the use of vancomycin powder did not impact the development of surgical site infection (OR 0.743 [95% CI 0.270–2.04], p = 0.564) and (OR 0.583 [95% CI 0.198–1.718], p = 0.328), respectively. CONCLUSIONS Within the context of an ongoing debate on the effectiveness of locally administered vancomycin powder, the authors found no significant difference in the incidence of deep wound infection rates after posterior cervical fusion surgery with routine use of locally applied vancomycin powder. Future prospective randomized series are needed to corroborate these results.

Decreased Risk of Wound Infection After Posterior Cervical Fusion With Routine Local Application of Vancomycin Powder

Spine ◽  
2013 ◽  
Vol 38 (12) ◽  
pp. 991-994 ◽  
Author(s):  
Russell G. Strom ◽  
Donato Pacione ◽  
Stephen P. Kalhorn ◽  
Anthony K. Frempong-Boadu
Keyword(s):  
Wound Infection ◽  
Local Application ◽  
Cervical Fusion ◽  
Vancomycin Powder ◽  
Posterior Cervical Fusion

scholarly journals AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY

2015 ◽  
Vol 7 (4) ◽  
pp. 38-42 ◽  
Author(s):  
A V Sotnikov ◽  
V M Melnikov ◽  
R V Almadi ◽  
G N Gorbunov
Keyword(s):  
Cardiac Surgery ◽  
Wound Infection ◽  
Incidence Rate ◽  
Control Group ◽  
Study Group ◽  
Intravenous Injections ◽  
Deep Wound Infection ◽  
Period 2 ◽  
Deep Wound

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.

Offset layered closure reduces deep wound infection in early-onset scoliosis surgery

2016 ◽  
Vol 25 (4) ◽  
pp. 361-368 ◽  
Author(s):  
Alexandra M. Grzywna ◽  
Patricia E. Miller ◽  
Michael P. Glotzbecker ◽  
John B. Emans
Keyword(s):  
Wound Infection ◽  
Early Onset ◽  
Early Onset Scoliosis ◽  
Scoliosis Surgery ◽  
Deep Wound Infection ◽  
Deep Wound

Paravertebral foramen screw fixation for posterior cervical spine surgery: clinical case series

2021 ◽  
pp. 1-8
Author(s):  
Tomoaki Shimizu ◽  
Masao Koda ◽  
Tetsuya Abe ◽  
Tomoyuki Asada ◽  
Kosuke Sato ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Revision Surgery ◽  
Posterior Wall ◽  
Cervical Fusion ◽  
Screw Loosening ◽  
Transverse Foramen ◽  
Fusion Surgery ◽  
Cervical Spine Surgery ◽  
Intermediate Group ◽  
Posterior Cervical Fusion

OBJECTIVE The goal of this study was to clarify the clinical utility of paravertebral foramen screws (PVFSs) and to determine intraoperative indicators for appropriate screw placement during posterior cervical fusion surgery to improve its safety. METHODS The authors included data from 46 patients (29 men and 17 women, mean age 61.7 years) who underwent posterior cervical spine surgery with 94 PVFSs. Of the 94 PVFSs, 77 were used in C6, 9 in C3, 5 in C4, and 3 in C5. According to the cervical lateral radiographic view, the authors divided the 94 PVFSs into 3 groups as follows: a longer group, in which the tip of PVFS was located anteriorly from the line of the posterior wall of the vertebral body (> +0 mm); an intermediate group, in which the screw tip was located up to 2 mm posteriorly to the posterior wall of the vertebral body (–2 to 0 mm); and a shorter group, in which the screw tip was located more than 2 mm posteriorly (< –2 mm). The accuracy of screw placement was assessed using CT imaging in the axial plane, and the proportion of screws penetrating a vertebral foramen or a transverse foramen was compared between the 3 groups. Screw loosening was defined as a lucent zone around the screw evaluated on cervical radiography at 1 year after surgery. Complications related to PVFS insertion and revision surgery related to PVFS were evaluated. RESULTS The authors classified 25 PVFSs into the longer group, 43 into the intermediate group, and 26 into the shorter group. The proportion of screws penetrating a vertebral foramen was largest in the shorter group, and the proportion penetrating a transverse foramen was largest in the longer group. Screw loosening was confirmed for 3 of 94 PVFSs. One PVFS inserted in C6 unilaterally within a long construct from C2 to C7 showed loosening, but it did not cause clinical symptoms. Revision surgery was required for 2 PVFSs inserted in C3 bilaterally as the lower instrumented vertebra in occiput–cervical fusion because they pulled out. There was no neurovascular complication related to PVFS insertion. CONCLUSIONS PVFSs are useful for posterior cervical fusion surgery as alternative anchor screws, and the line of the posterior wall of the cervical body on lateral fluoroscopic images is a potential intraoperative reference to indicate an appropriate trajectory for PVFSs.

scholarly journals Effective Protocol to Treat Patients with Deep Wound Infection after Spinal Lumbar Fusion

2015 ◽  
Vol 5 (1_suppl) ◽  
pp. s-0035-1554547-s-0035-1554547
Author(s):  
Asdrubal Falavigna ◽  
Orlando Righesso ◽  
Alisson Roberto Teles ◽  
Pedro Guarise da Silva ◽  
Francisco Bassanesi
Keyword(s):  
Wound Infection ◽  
Lumbar Fusion ◽  
Deep Wound Infection ◽  
Deep Wound

Intrawound Vancomycin Powder Reduces Surgical Site Infections in Posterior Cervical Fusion

Spine ◽  
2013 ◽  
Vol 38 (14) ◽  
pp. 1183-1187 ◽  
Author(s):  
Cyrus Caroom ◽  
Jessica M. Tullar ◽  
E. Garrison Benton ◽  
Jason R. Jones ◽  
Christopher D. Chaput
Keyword(s):  
Surgical Site Infections ◽  
Cervical Fusion ◽  
Vancomycin Powder ◽  
Posterior Cervical Fusion

Deep wound infection after proximal femoral fracture: consequences and costs

2006 ◽  
Vol 63 (2) ◽  
pp. 133-139 ◽  
Author(s):  
T.C.B. Pollard ◽  
J.E. Newman ◽  
N.J. Barlow ◽  
J.D. Price ◽  
K.M. Willett
Keyword(s):  
Wound Infection ◽  
Femoral Fracture ◽  
Proximal Femoral Fracture ◽  
Deep Wound Infection ◽  
Deep Wound

Wide variation in risk of wound infection following clean neurosurgery

1985 ◽  
Vol 62 (2) ◽  
pp. 243-247 ◽  
Author(s):  
James H. Tenney ◽  
David Vlahov ◽  
Michael Salcman ◽  
Thomas B. Ducker
Keyword(s):  
Wound Infection ◽  
Wound Infection Rate ◽  
Neurosurgical Procedures ◽  
Postoperative Wound Infection ◽  
Content Type ◽  
Postoperative Wound ◽  
Deep Wound Infection ◽  
Deep Wound ◽  
Potential Efficacy ◽  
Perioperative Antibiotics

✓ The authors have prospectively examined the occurrence of postoperative wound infection following clean neurosurgery in 936 patients. Fewer than 1% received perioperative antibiotic prophylaxis. The overall rate of deep wound infection was 2.6%; no deaths were directly attributable to these infections. Deep wound infections occurred significantly more frequently following craniotomy (4.3%) than following spinal (0.9%) or other clean neurosurgery. Among craniotomies, the deep wound infection rate varied significantly from 11% following repeat operations for recurrent gliomas to 2.5% following non-tumor surgery. Risk of deep wound infection varied more than 11-fold depending on the type of clean neurosurgical operation. It is most feasible to demonstrate the potential efficacy of perioperative antibiotics in clean neurosurgical procedures with the greatest risk of postoperative wound infection. The potential benefit from such prophylaxis would be greatest for patients undergoing these high-risk operations.

Comparison of Deep Wound Infection Rates Using a Synthetic Dural Substitute (Neuro-Patch) or Pericranium Graft for Dural Closure: A Clinical Review of 1 Year

Neurosurgery ◽  
2004 ◽  
Vol 54 (3) ◽  
pp. 599-604 ◽  
Author(s):  
Miriam Malliti ◽  
Philippe Page ◽  
Charles Gury ◽  
Eric Chomette ◽  
François Nataf ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Wound Infection ◽  
The Body ◽  
Infection Rates ◽  
Septic Complications ◽  
Dural Closure ◽  
Deep Wound Infection ◽  
Deep Wound ◽  
Clinical Series ◽  
Duration Of Surgery

Abstract OBJECTIVE The need to repair dural defects has prompted the use of dura mater substitutes. Many synthetic materials have been used for dural closure. Neuro-Patch (B. Braun Médical S.A., Boulogne, France) is a nonabsorbable microporous fleece composed of polyester urethane that has been approved for human use by the European Union since 1995. To the best of our knowledge, no clinical series with Neuro-Patch have been published thus far, particularly with regard to septic complications. The aim of our study was to compare the safety of Neuro-Patch with that of pericranium graft with regard to postoperative wound infections. METHODS This is a retrospective study of 1 year's experience including all patients who underwent dural plasty with a Neuro-Patch (n = 61) or pericranium graft (n = 63). The follow-up period was at least 12 months after surgery. Before wound infection rates in the two groups were compared, factors suspected of being risks for neurosurgical site infection were evaluated. RESULTS Patient characteristics (mean age, neurological diagnosis), surgical procedures, prophylactic antibiotics, and risk factors for surgical infections (including duration of surgery, emergency, contaminated operations, and external cerebrospinal fluid drainage) were similar in the Neuro-Patch and pericranium groups. Deep wound infection rates in the Neuro-Patch and pericranium groups were 15 and 5%, respectively (P = 0.06), and cerebrospinal fluid leaks were significantly more frequent in the Neuro-Patch group (13 versus 1.6%, P &lt; 0.05). CONCLUSION The results of our investigations show that Neuro-Patch raised the risk of wound infection, as do foreign materials implanted in the body. Synthetic dural grafts should be reserved for when autologous grafts are not sufficient or possible. An extensive prospective multicenter randomized trial is needed to confirm our results.

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