Risk Factors for Wound Infections after Deformity Correction Surgery in Neuromuscular Scoliosis
| Autor: | Michael E. Sebert, Amer F. Samdani, M. Burhan Janjua, Dale M. Swift, Brandon J Toll, Shashank Ghandi, Steven W. Hwang, Joshua M. Pahys |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Deformity correction Body weight Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Surgical Wound Infection Significant risk Child Retrospective Studies Neuromuscular scoliosis business.industry General Medicine Perioperative medicine.disease Comorbidity Surgery Spinal Fusion Scoliosis 030220 oncology & carcinogenesis Spinal fusion Pediatrics Perinatology and Child Health Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies Pediatric population |
| Zdroj: | Pediatric Neurosurgery. 54:108-115 |
| ISSN: | 1423-0305 1016-2291 |
| Popis: | Objective: This study aims to elucidate surgical risk factors in neuromuscular scoliosis (NMS) with respect to wound site infection after spinal fusion. Methods: A retrospective review was performed of all patients treated surgically for NMS between January 2008 and December 2016 (minimum 6 months’ follow-up). A sub-cohort of 60 patients with minimum 2 years of follow-up data was also analyzed. Results: In 102 patients (53 boys and 49 girls), the mean age at surgery was 14.0 years (SD ±2.7). Mean follow-up was 2.53 years (±1.66), and mean time to presentation of infection was 2.14 months (±4.95). The overall perioperative complication rate was 26.5%, with 14.7% of patients developing deep wound infection. Gram-negative bacteria were responsible for 60% of infections; 20% were Gram positive, and 20% involved both types. Pulmonary comorbidities (p = 0.007), pre- to postoperative increase in weight (p = 0.010), exaggerated lumbar lordosis at follow-up (p = 0.008), history of seizures (p = 0.046), previous myelomeningocele repair (p = 0.046), and previous operations (p = 0.013) were significant risk factors for infection. Conclusion: Our data suggest that in the pediatric population treated surgically for NMS, wound infection is strongly associated with postoperative increase in body weight, residual lumbar lordosis, pulmonary comorbidity, history of myelomeningocele repair, seizures, and previous operations. |
| Databáze: | OpenAIRE |
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