Incidence of surgical site infections after cervical spine surgery: results of a single-center cohort study adhering to multimodal preventive wound control protocol

Abstract

Purpose The incidence of surgical site infections is considered a relevant indicator of perioperative and postoperative care quality. The aim of this study is to analyze and evaluate SSIs after elective cervical spine surgery under the guidance of our preventive multimodal wound protocol. Methods A monocentric observational cohort study analyzed 797 patients who underwent cervical spine surgery from 2005 to 2010 (mean age 51.58 ± 11.74 year, male 56.09%, mean BMI 26.87 ± 4.41, ASA score 1–2 in 81.68% of patients), fulfilling the entry criteria: (1) cervical spine surgery performed by neurosurgeons (degenerative disease 85.19%, trauma 11.04%, tumor 3.76%), (2) elective surgery, (3) postoperative care in our neurointensive care unit. Our preventive wound control protocol management focused mainly on antibiotic prophylaxis, wound hygiene regime, and drainage equipment. All wound complications and surgical site infections were monitored up for 1 year after surgery. Results We had only 2 (0.25%) patients with SSI after cervical spine surgery—one organ/space infection (osteomyelitis, primary due to liquorrhea) after anterior surgical approach, and one deep surgical site infection (due to dehiscence) after posterior approach. We had 17 (2.13%) patients with some wound complications (secretion 7, dehiscence 4, hematoma 1, edema 3, and liquorrhea 2) that were not classified as SSI according to the CDC guidelines. Conclusion Concerning our study population of patients undergoing elective cervical surgery, with ASA scores 1–2 in 81.68% of our patients, the incidence of SSI was 0.14% after anterior surgical approach, 1.4% after posterior surgical approach, and 0.25% altogether in the referred cohort.

Wound Microbiota and Its Impact on Wound Healing

“…The occurrence of SSIs in neurosurgical procedures, including cervical spine surgeries, is influenced by multiple factors such as the nature of the surgical procedure, patient-specific characteristics, and the implementation of preventive strategies. A noteworthy study that analyzed a cohort of 797 patients undergoing cervical spine surgery reported an even lower incidence of SSIs (0.25%) [28]. In their retrospective analysis, Cao et al scrutinized a significant sample of 808 cases involving patients who underwent clean neurosurgical operations.…”

Incidence and risk factors of surgical site infection following cervical laminoplasty: A retrospective clinical study

“…Compared with lumbar surgeries, cervical surgery cases were associated with a significantly lower rate of infection 5 . Meanwhile, posterior cervical spine surgeries cases had a significantly higher rate of infection than anterior cervical surgeries cases with consequences ranging from superficial to deep infection 6,7 . Cervical laminoplasty is the most widely used procedure in posterior cervical surgery 8,9 .…”

“… 5 Meanwhile, posterior cervical spine surgeries cases had a significantly higher rate of infection than anterior cervical surgeries cases with consequences ranging from superficial to deep infection. 6 , 7 Cervical laminoplasty is the most widely used procedure in posterior cervical surgery. 8 , 9 Because it prevents the formation of epidural scarring while maintaining the integrity of the posterior neck muscles.…”