Closed Suction Irrigation for the Treatment of Postoperative Wound Infections Following Posterior Spinal Fusion and Instrumentation

Rohmiller, Michael T.; Akbarnia, Behrooz A.; Raiszadeh, Kian; Raiszadeh, Kamshad; Canale, Sarah

doi:10.1097/brs.0b013e3181b616eb

Cited by 54 publications

(46 citation statements)

References 15 publications

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“…Surgical management of postoperative infection after spinal instrumentation includes removal of the purulent material, irrigation and debridement, continuous irrigation systems, prophylactic removal of hardware, and utilization of adjunct measures such as wound vacuums. [15][16][17] Prophylactic removal of spinal instrumentation has been advocated to minimize the risk of infection relapse. 18 Other researchers have advocated removal of spinal implants based on the nature of microbiological isolates especially if fastidious organisms such as Propionibacter are identified.…”

Section: Discussionmentioning

confidence: 99%

Preservation of Spinal Instrumentation After Development of Postoperative Bacterial Infections in Patients Undergoing Spinal Arthrodesis

Ahmed

Greenlee

Traynelis

2012

Journal of Spinal Disorders & Techniques

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A combination of aggressive surgical debridement with microbial-guided pharmacotherapy enabled infection cure in all patients with postoperative bacterial infections after spinal instrumentation. Adjunct measures including the use of wound vacuum devices and long-term suppressive antimicrobial therapy were also used in high-risk patients. These results show that postoperative bacterial infections in the setting of spinal instrumentation can be successfully treated without removing titanium alloy instrumentation.

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Section: Discussionmentioning

confidence: 99%

Preservation of Spinal Instrumentation After Development of Postoperative Bacterial Infections in Patients Undergoing Spinal Arthrodesis

Ahmed

Greenlee

Traynelis

2012

Journal of Spinal Disorders & Techniques

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“…One third of patients developed a recurrent infection, which resolved after a second course of closed suction irrigation management. No patients required implant removal [68].…”

Section: Management Of Acute Deep Ssismentioning

confidence: 99%

Surgical site infection after pediatric spinal deformity surgery

Glotzbecker

Hedequist

2012

Curr Rev Musculoskelet Med

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The incidence of surgical site infection (SSI) after spinal deformity surgery for adolescent idiopathic scoliosis ranges from 0.5-6.7%. The risk of infection following spinal fusion in patients with neuromuscular scoliosis is greater, with reported rates of 6.1-15.2% for cerebral palsy and 8-41.7% for myelodysplasia. SSIs result in increased patient morbidity, multiple operations, prolonged hospital stays, and significant financial costs. Recent literature has focused on elucidating the most common organisms involved in SSIs, as well as identifying modifiable risk factors and prevention strategies that may decrease the rates of infection. These include malnutrition, positive urine cultures, antibiotic prophylaxis, surgical site antisepsis, antibioticloaded allograft, local application of antibiotics, and irrigation solutions. Acute and delayed SSIs are managed differently. Removal of instrumentation is required for effective treatment of delayed SSIs. This review article examines the current literature on the prevention and management of SSIs after pediatric spinal deformity surgery.

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“…According to Rohmiller et al [54], a closed suction irrigation system (CSIS) is effective for treating postoperative wound infections following instrumented spinal fusion, thus avoiding the need for secondary closure. In their retrospective record review of 500 posterior instrumented fusions between 1990 and 2002, 28 consecutive infections (5%) were diagnosed and treated by a standardised incision and drainage treatment protocol and CSIS:.…”

Section: Closed Suction Irrigation System (Csis)mentioning

confidence: 99%

Infections in spinal instrumentation

Gerometta

Olaverri

Bitan

2012

International Orthopaedics (SICOT)

131

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Surgical-site infection (SSI ) in the spine is a serious postoperative complication. Factors such as posterior surgical approach, arthrodesis, use of spinal instrumentation, age, obesity, diabetes, tobacco use, operating-room environment and estimated blood loss are well established in the literature to affect the risk of infection. Infection after spine surgery with instrumentation is becoming a common pathology. The reported infection rates range from 0.7% to 11.9%, depending on the diagnosis and complexity of the procedure. Besides operative factors, patient characteristics could also account for increased infection rates. These infections after instrumented spinal fusion are particularly difficult to manage due to the implanted, and possibly infected, instrumentation. Because the medical, economic and social costs of SSI after spinal instrumentation are enormous, any significant reduction in risks will pay dividends. The goal of this literature review was to analyse risk factors, causative organisms, diagnostic elements (both clinical and biological), different treatment options and their efficiency and consequences and the means of SSI prevention.

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Closed Suction Irrigation for the Treatment of Postoperative Wound Infections Following Posterior Spinal Fusion and Instrumentation

Cited by 54 publications

References 15 publications

Preservation of Spinal Instrumentation After Development of Postoperative Bacterial Infections in Patients Undergoing Spinal Arthrodesis

Preservation of Spinal Instrumentation After Development of Postoperative Bacterial Infections in Patients Undergoing Spinal Arthrodesis

Surgical site infection after pediatric spinal deformity surgery

Infections in spinal instrumentation

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