Postoperative Posterior Spinal Wound Infections

Massie, Jennifer B.; Heller, John G.; Abitbol, Jean-Jacques; Mcpherson, Diana; Garfin, Steven R.

doi:10.1097/00003086-199211000-00013

Cited by 236 publications

(191 citation statements)

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“…The occurrence of meningitis as a complication of spinal surgery, observed in one of our patients, although rare with an incidence of about 0.18% [31], has also been reported by others [3,21].…”

Section: Discussionsupporting

confidence: 87%

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Defino

Rodriguez-Fuentes

1998

E Spine J

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Section: Discussionsupporting

confidence: 87%

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Defino

Rodriguez-Fuentes

1998

E Spine J

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“…The risk factors compromising local perfusion and thus predisposing an infection are diabetes, smoking, alcohol abuse, immune deficiency in case of malignancy, morbid obesity, cardiovascular problems and radiation before surgery [24,42,60]. A recent study described that trauma patients enter a catabolic state after an injury and emphasised the importance of monitoring the caloric intake and of securing positive protein balance [30,54].…”

Section: Discussionmentioning

confidence: 99%

“…Its incidence rate amounts to 0.4-20% [40,59,65,66,68], increasing with the complexity of the procedure being the highest for fusion with instrumentation [21,42,57]. Most infections occur after posterior instrumentation [39,69].…”

Section: Introductionmentioning

confidence: 99%

“…Instrument removal of infected spinal wounds is recommended by some authors [55,58,62]. Irrigation-suction systems were also used in the management of infected spinal wounds [39,42,58,61]. Delayed primary closure of the infected spinal wound up to wound healing by secondary intent are described procedures [59,60].…”

Section: Introductionmentioning

confidence: 99%

“…Delayed primary closure of the infected spinal wound up to wound healing by secondary intent are described procedures [59,60]. Recently, some authors showed that instrumentation salvage is possible when techniques such as serial debridements, antibiotic medication, irrigation-suction systems and delayed primary closure of the wound are used [39,42,51,54,59,60,65]. Primary or delayed primary closure is often not possible and muscle flaps are required to close the dead space and to provide soft tissue coverage [15,27,46,63].…”

Section: Introductionmentioning

confidence: 99%

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Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

et al. 2006

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The use of vacuum assisted closure (V.A.C.) therapy in postoperative infections after dorsal spinal surgery was studied retrospectively. Successful treatment was defined as a stable healed wound that showed no signs of acute or chronic infection. The treatment of the infected back wounds consisted of repeated debridement, irrigation and open wound treatment with temporary closure by V.A.C. The instrumentation was exchanged or removed if necessary. Fifteen patients with deep subfascial infections after posterior spinal surgery were treated. The implants were exchanged in seven cases, removed completely in five cases and left without changing in one case. In two cases spinal surgery consisted of laminectomy without instrumentation. In two cases only the wound defects were closed by muscle flap, the remaining ones were closed by delayed suturing. Antibiotic treatment was necessary in all cases. Follow up was possible in 14 patients. One patient showed a new infection after treatment. The study illustrates the usefulness of V.A.C. therapy as a new alternative management for wound conditioning of complex back wounds after deep subfascial infection.

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Unique Antimicrobial Effects of Platelet‐Rich Plasma and Its Efficacy as a Prophylaxis to Prevent Implant‐Associated Spinal Infection

Hamza

Tidwell

et al. 2013

Adv Healthcare Materials

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Platelet-rich-plasma (PRP) has attracted great attention and has been increasingly used for a variety of clinical applications including orthopaedic surgeries, periodontal and oral surgeries, maxillofacial surgeries, plastic surgeries, and sports medicine. However, very little is known about the antimicrobial activities of PRP. In this study, PRP is found to have antimicrobial properties both in vitro and in vivo. In vitro, the antimicrobial properties of PRP have been found to be bacterial strain specific and time specific: PRP has significantly (80–100 fold reduction in colony forming units) inhibited the growth of methicillin sensitive and methicillin resistant Staphylococcus aureus, Group A streptococcus, and Neisseria gonorrhoeae within the first few hours but it has no significant antimicrobial properties against E. coli and Pseudomonas. The antimicrobial properties of PRP also depend on the concentration of thrombin. In vivo, an implant-associated spinal infection rabbit model has been established and used to evaluate the antimicrobial and wound healing properties of PRP. Compared to the infection controls, PRP treatment has resulted in significant reduction in bacterial colonies in bone samples at all time points studied (i.e. 1, 2, and 3 weeks) and significant increase in mineralized tissues (thereby better bone healing) at post-operative weeks 2 and 3. PRP therefore may be a useful adjunct strategy against post-operative implant-associated infections.

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Postoperative Posterior Spinal Wound Infections

Cited by 236 publications

References 0 publications

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Treatment of fractures of the thoracolumbar spine by combined anteroposterior fixation using the Harms method

Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

Unique Antimicrobial Effects of Platelet‐Rich Plasma and Its Efficacy as a Prophylaxis to Prevent Implant‐Associated Spinal Infection

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