Reducing Surgical Site Infections in Spine Tumor Surgery
| Autor: | Eric Emanski, David N. Bernstein, Avionna Baldwin, Addisu Mesfin, Robert W. Molinari, Emmanuel N. Menga, Paul T. Rubery |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Administration Topical Therapeutic irrigation Body Mass Index Young Adult 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Vancomycin medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine Young adult Child Therapeutic Irrigation Povidone-Iodine Aged Retrospective Studies Aged 80 and over 030222 orthopedics Spinal Neoplasms business.industry Case-control study Retrospective cohort study Odds ratio Middle Aged Anti-Bacterial Agents Surgery Case-Control Studies Child Preschool Drug Therapy Combination Female Neurology (clinical) Powders Complication business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Spine. 44:E1428-E1435 |
| ISSN: | 1528-1159 0362-2436 |
| Popis: | Study design Case control series. Objective The aim of this study was to evaluate and compare the effectiveness of methods to decrease surgical site infections (SSIs) following spine tumor surgery. Summary of background data With the aging population of the United States, the prevalence of cancer and associated metastatic spine disease is increasing. The most common complication of spine tumor surgery is SSI. Methods This a single-institution case-control series of patients undergoing spine tumor surgery from June 2003 to October 2018. Patients were grouped into the following groups: Betadine irrigation and intrawound vancomycin powder (BIVP), intrawound vancomycin powder only (IVP), and patients receiving neither (NONE). The primary outcome was SSIs/wound complications. Results One hundred fifty-one spine tumor patients undergoing 174 procedures meeting our inclusion criteria were identified. The BIVP group had 60 patients (73 procedures); the IVP group had 46 patients (47 procedures); and the NONE group had 45 patients (54 procedures). The overall infection rate was 8.6% of all procedures (15/174) and 9.9% (15/151) of all patients. Bivariate analysis comparing patients with and without infections noted the patients with SSIs had significantly higher rates of preoperative radiation treatment (53.3% in infection group vs. 25.5% in noninfection group), P = 0.02. Patients undergoing procedures in the BIVP group had a significantly lower rate of infections (2.7%) than the patients in the IVP (12.8%) and NONE (13%) groups, P = 0.04. Stepwise regression analysis was used to evaluate further factors associated with SSIs. Elevated BMI was significantly associated with SSIs in the model [P = 0.02, odds ratio (OR) 1.14]. BIVP was also protective against infections as compared to the IVP and NONE groups, P = 0.02, OR 0.02. Conclusion BIVP led to a significant decrease in SSI rates following spine tumor surgery. Administration of BIVP is not time consuming and decreased SSI rates. Level of evidence 3. |
| Databáze: | OpenAIRE |
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