After spinal surgery, postoperative infection is still a problem. Infection rates following spine surgery have decreased thanks to institutional infection prevention practices. On the other hand, prior research had only looked at patients who had undergone elective surgery. The goal of this study was to see how effective a multi-institutional intraoperative sodium oxychlorosene–based infection prevention approach was at lowering infection rates following instrumented spinal surgery. At two tertiary care institutions with level I trauma programs, surgeons measured postoperative deep wound infection rates before and after implementing a multi-institutional infection prevention plan. The potential for infection prevention techniques to have negative implications was also looked into.
A total of 5047 patients met the criteria for inclusion. Before the implementation of the regimen, 1043 patients had surgery. This cohort’s infection rate (3.5%) reduced dramatically when the treatment was implemented (1.2%, p < 0.001). The pre and post protocol groups had the same postoperative sterile seroma rates (0.7% vs 0.7%, p = 0.5). The fusion rate was 89.2% in the 1031 patients who had surgery between January 2018 and May 2019. Patients with infection and those without a problem exhibited the similar quality of life outcomes, despite the limited statistical power. Notably, infection-related complications claimed the lives of two out of every ten patients who acquired a deep wound infection. An intraoperative sodium oxychlorosene-based infection prevention approach helped reduce the rate of infection following spine surgery while having no detrimental effects on other postoperative procedure-related metrics. A higher-than-expected percentage of postoperative death may be linked to postoperative wound infection.
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