Postoperative Wound Infections Complicating Adult Spine Surgery

Stambough, Jeffery L.; Beringer, Donald

doi:10.1097/00002517-199209000-00005

Cited by 105 publications

(62 citation statements)

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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%

“…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]. 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].…”

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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…Jensen et al (1982) have reported nutritional deterioration in orthopedic surgery patients and have related nutritional status with the development of postoperative complications. Stambough and Beringer (1992) as well as Mandelbaum et al (1988) found a clear relationship between spinal surgery postoperative infections and nutritional depletion. MacBurney and Wilmore (1981) demonstrated a direct relationship between the magnitude of the surgical procedure and increases in caloric and protein requirements.…”

Section: Introductionmentioning

confidence: 89%

Analysis of nutritional parameters in idiopathic scoliosis patients after major spinal surgery

et al. 2005

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Objective: The aim of the study is to investigate the evolution of nutritional parameters after major spinal surgery in patients with idiopathic scoliosis. Methods: This retrospective study included 31 patients with a mean age of 18 y, diagnosed with idiopathic scoliosis. The following variables were analyzed: demographic, surgical (type, number of fused segments, duration, and blood loss), nutritional assessment (proteins, albumin, prealbumin, transferrin, lymphocytes, and body mass index), and duration of hospitalization at different time points. Statistical analyses were performed with the SPSS 6.1 software. Results: Before surgery, nutritional status was normal in all patients. At 24-48 h after surgery, statistically significant decrease with respect to preoperative values was recorded for all the parameters studied: proteins (Po0.001), albumin (Po0.001), prealbumin (Po0.01), transferrin (Po0.001), and lymphocytes (Po0.001). Conclusion: Our results showed a significant postoperative decrease in the nutritional parameters analyzed in a previously wellnourished population considered to be at low risk for nutritional depletion.

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“…The increased infection rates are likely to be the result of procedure-related increases in operative time, blood loss, and tissue damage [1,2,6,9,17]. In order to manage a postoperative infection of an instrumented spine, most surgeons agree that removal of implants might be unnecessary, particularly in the early stages of a postoperative Abstract The recommended surgical options for postoperative wound infections after instrumented spine surgery include a wide debridement and irrigation with antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Postoperative spondylitis after posterior lumbar interbody fusion using cages

Kim

2004

Eur Spine J

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Postoperative Wound Infections Complicating Adult Spine Surgery

Cited by 105 publications

References 0 publications

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

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

Analysis of nutritional parameters in idiopathic scoliosis patients after major spinal surgery

Postoperative spondylitis after posterior lumbar interbody fusion using cages

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