Surgical site infection in spinal metastasis: incidence and risk factors

Sebaaly, Amer; Shédid, Daniel; Boubez, Ghassan; Zaïri, Fahed; Kanhonou, Michelle; Yuh, Sung-Joo; Zhi, Wang

doi:10.1016/j.spinee.2018.01.002

Cited by 48 publications

(32 citation statements)

References 34 publications

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“…For the sake of practicability, we renounced on differentiating between elective and traumatic oncologic surgery upon pathological fractures, between superficial and deep SSIs (4,14), between primary cancer surgery and metastases, or the reasons of SSIs ("direct" SSI or indirectly by contaminated allografts during the same first intervention); or due to second looks during the same hospitalization. The reasons for not distinguishing superficial and deep SSIs were multiple: a) most oncologic orthopedic articles do not differentiate between deep organ and superficial scar infections, b) many orthopedic cancers have superficial and deep parts, c) our goal was not to compare the numbers between the centers, and d) this distinction is interesting for epidemiological surveillances and therapies, but not regarding antibiotic prophylaxis.…”

Section: Methodsmentioning

confidence: 99%

“…Various first-or second generation cephalosporins were the most frequently used prophylactic agents, but their prophylactic durations varied between 1 and 5 days (17, Table 1). Many authors maintain a standard prophylactic preoperative antibiotic regimen of cephalosporin for a maximum of 24 hours after surgery despite reporting SSI rates of up to 15% (10,28) and do not discuss their attitude and motives (14,28). A large Japanese center with almost 500 own cases remains with a 24 h prophylaxis, even though many of their cases involve technically difficult surgeries such as hip disarticulations, pelvectomies and others (2).…”

Section: Duration Of Antibiotic Prophylaxismentioning

confidence: 99%

“…Besides additional costs, oncologic SSIs are serious complications that may have a relevant influence on the patient's survival time (13). Without a doubt, they certainly prolong the length of the stay in acute hospital settings (4,14) and may postpone a mandatory postoperative chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections in Orthopaedic Oncology - A Narrative Review of Current Concepts

Müller

Kaiser

Sairanen

et al. 2019

J. Bone Joint Infect.

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Abstract. The incidence of surgical site infections (SSIs) after elective tumour orthopaedic surgery in adults is higher than non-oncologic orthopaedic surgery. Their causative microorganisms and antibiotic susceptibilities are also different from the non-oncologic cases; with no apparent predictable microbiological patterns. Clinicians continue to struggle to tailor the optimal prophylactic regimen for the very heterogeneous group of tumour patients. Many clinicians thus prolong the first-and second-generation cephalosporin agents, while a minority chooses to broaden the antimicrobial spectrum by combination prophylaxis. The variability in current practices and surgical techniques is enormous, even within the same setting. The scientific literature lacks adequate retrospective case-studies and there is currently only one prospective randomized trial. In this narrative review, we discuss various perioperative antibiotic concepts in oncologic orthopaedic surgery, including a summary of the state-to-the-art, opinions and difficulties related to the different prophylactic strategies.

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Section: Methodsmentioning

confidence: 99%

Section: Duration Of Antibiotic Prophylaxismentioning

confidence: 99%

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Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections in Orthopaedic Oncology - A Narrative Review of Current Concepts

Müller

Kaiser

Sairanen

et al. 2019

J. Bone Joint Infect.

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“…Повышенный ИМТ в нашем исследовании не являлся статистически значимым фактором риска ИОХВ, однако по литературным данным, увеличение ИМТ более 25 кг/м 2 связано с 15% увеличением риска послеоперационных инфекционных осложнений [5,7].…”

Section: таблица 3 анализ качественных факторов риска в группах с помunclassified

“…Основные факторы, способствующие развитию ИОХВ, можно разделить на три категории: связанные с пациентом; связанные с течением основного заболевания и связанные с видом противоопухолевой терапии [5,6]. Кроме того, огром-ное влияние на развитие ранних воспалительных изменений оказывают длительность и тяжесть оперативного вмешательства [7].…”

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Risk Factors for Infectious Complications after Surgical Treatment of Spinal Metastases in Patients with Breast and Kidney Cancer

Смекалёнков

Пташников

Zaborovskii

et al. 2019

Traumatology and Orthopedics of Russia

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Relevance. In patients with the most common malignant new growth such as breast, kidney and lung cancer the rate of spinal metastases amounts to 70%. Increasing number of surgical procedures results in growing frequency of postoperative complications including surgical site infection (SSI) which do not only deteriorate the quality of patient’s life but change the timelines for renewal of therapy for the primary disease. Study design — case control study. Purpose of the study — to identify key risk factors as well as impact of tumor therapy on development of infectious complications in patients with breast and kidney cancer after surgical management of metastatic spine lesion. Materials and Methods. The authors collected and compiled the data on 2023 oncological patients who underwent specialized neuroorthopaedic treatment in the period from 2000 until 2017 due to tumor spine lesions. Inclusion criteria: malignant breast and kidney tumors with spine metastases, continued systemic tumor therapy, decompression and stabilization spine surgery irrespective of used implants. Patients that corresponded to inclusion criteria were divided into two groups. The first (main) group included patients (n = 22) with infectious complications after surgery. The second (control) group (n = 23) was formed by propensity score matching. Results. The analysis of obtained data resulted in identification of severe significant factors (р0.05): diabetes mellitus, postoperative liquorrhea, certain classes by ASA (3, 4) and ECOG (2, 3, 4) scales, volume of blood loss, time of surgery and type of tumor therapy. However, the three latter have the highest statistical significance (р0.01): surgical factors (blood loss volume and time of procedure) and type of tumor therapy. Conclusion. Postoperative SSI remains a common severe complication after surgeries due to metastatic spine lesions. The causes of postoperative infection after tumor resection are compromised immune status of the patient; long time of procedure with heavy blood loss and adjuvant tumor therapy.

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Postoperative Complications and Spinal Metastases

Yasin

Virk

2020

Central Nervous System Metastases

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Surgical site infection in spinal metastasis: incidence and risk factors

Cited by 48 publications

References 34 publications

Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections in Orthopaedic Oncology - A Narrative Review of Current Concepts

Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections in Orthopaedic Oncology - A Narrative Review of Current Concepts

Risk Factors for Infectious Complications after Surgical Treatment of Spinal Metastases in Patients with Breast and Kidney Cancer

Postoperative Complications and Spinal Metastases

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