Reduced Surgical Site Infection Rates Following Spine Surgery Using an Enhanced Prophylaxis Protocol

Abstract

BackgroundPostoperative surgical site infection (SSI) is a common complication after spine surgery. Reduction of SSI has many benefits including, but not limited to, the reduced length of stay, readmission rates, and morbidity and mortality.ObjectiveTo determine whether an enhanced antibiotic prophylaxis reduced the rate of surgical site infections in spine surgery.MethodsThis is a retrospective observation study which analyzed the incidence of postoperative SSI following a consecutive series of 1,486 cervical, thoracic and lumbar spine operations performed at a single institution by the senior author between the dates of October 2001 to March 2014. Patients with surgeries between October 2001 and November 2005 received a standard institutional antibiotic prophylaxis. Patients between December 2005 and March 2014 underwent an enhanced antibiotic protocol.ResultsA total of nine cases met the criteria for SSI. All nine cases were recorded during the initial time period when the standard institutional prophylaxis was used. Further, these cases were only observed under posterior operative approaches. No further cases of SSI were observed after the institution of the enhanced antibiotic prophylaxis (p < 0.0001). This was statistically significant in the cervical and lumbar regions (p < 0.0042 and p < 0.0119, respectively).ConclusionsAlthough difficult to predict the incidence of SSI, this study found that the use of an enhanced antibiotic prophylaxis protocol significantly reduced one surgeon’s overall rates of surgical site infections after spine surgery.

Surgical Site Infection Following Open Posterior Spine Surgery: Which is the Most Affected?

“…Our result revealed that age 41-66 years was the commonest group with spinal disorders ( Table 1). Previous studies found that the mean age for spinal disorder ranges from 44.2±16.0 to 63±14 years (5)(6)(7)(8)10,12,14,16,18,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). This indicates that our result was consistent with previous findings.…”

“…Moreover, twenty studies reported were identified from PubMed and EMBASE regarding the incidence of SSI following spine surgery. They reported the incidence vary, ranging from 0.2% to 16.1% (5)(6)(7)(8)10,12,14,16,18,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Our result showed that the incidence of SSI following spine surgery was 2.4%.…”

“…Our result was different with several studies. Studies found that trauma and or degenerative in cervical (8,18,27,28,32), thoracic (12), and lumbar spine (6,7,10) were the commonest cases associated with SSI. This difference could not be clearly explained.…”

Evaluation of Cumulative and Conditional Antibiotic Release from Vancomycin-Embedded Fibrin Sealant and Its Antibacterial Activity : An In Vitro Study

“…Surgical site infection (SSI) is a critical aspect in the surgical field. SSI occurs in 1.9% of surgeries, and varies among populations, surgical procedures, and instrumentation 3,10,12,13,15,24) . SSI results in a significant morbidity and financial burden due to longer hospital stay, readmission, and repeated procedures 3,5,18,34) .…”

Decreasing Surgical Site Infections after Ventral Hernia Repair: A Quality-Improvement Initiative

“…Common approaches have included standardizing care through evidencebased guidelines and centralizing care among specialists and high-volume surgeons. Although many specialties have described reductions in SSI rates among ventral hernia repair (VHR) cases [1][2][3], SSI remains prevalent. This may be attributable to multiple barriers specific to VHR.…”