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Results of using the infection avoidance Protocol for postoperative wounds in spinal surgery

https://doi.org/10.17650/1683-3295-2020-22-3-51-56

Abstract

Background. We developed a Protocol based on the results of a previous study of risk factors for infection of a postoperative wound: do not use monopolar coagulation on the skin and subcutaneous fat; remove hemostatic material from the wound; relax the established wound expander every 65 minutes; refuse to suture the muscles in the area of laminectomy, refuse to use an intradermal suture.

The study objective is a verification of the received Protocol.

Materials and methods. A comprehensive retrospective cohort study evaluated the results of surgical treatment of 575 spinal patients who were under the authors’ supervision in 2014–2016. Patients were divided into groups: operated in the period from 2014 to 2016 (control group), operated in 2017, in the treatment of which the Protocol for reducing complications was applied (main group).

Results. It was found that after the introduction of the Protocol, the percentage of patients with postoperative wound infection decreased from 6.0 to 1.3 %.

Conclusion. The resulting Protocol is an effective tool for reducing wound infection and can be recommended for prevention of the postoperative wound infection in patients with spinal with diseases and injuries.

About the Authors

A. A. Grin
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



A. K. Kaykov
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



A. Yu. Kordonskiy
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



V. A. Karanadze
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



O. A. Levina
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



L. V. Popkova
N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department
Russian Federation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



References

1. Krylov V.V., Grin A.A., Kaykov A.K. et al. Modern principles in surgery of injuries and diseases of the spine. Neotlozhnaya meditsinskaya pomoshch’. Zhurnal im. N.V. Sklifosovskogo = Russian Sklifosovsky Journal of Emergency Medical Care 2014;(4):36–41. (In Russ.).

2. Xing D., Ma J.X., Ma X.L. et al. A methodological, systematic review of evidence-based independent risk factors for surgical site infections after spinal surgery. Eur Spine J 2013;22(2):605–15. DOI: 10.1007/s00586-012-2514-6.

3. Olsen M.A., Mayfield J., Lauryssen C. et al. Risk factors for surgical site infection in spinal surgery. J Neurosurg 2003;98(2 Suppl):149–55.

4. Grin A.A., Kaykov A.K., Krylov V.V. The prophylaxis and treatment of various complications at patients with spinal trauma (part 2). Neyrokhirurgiya = Russian Journal of Neurosurgery 2015;(1):55–66. (In Russ.).

5. Grin A.A., Kaykov A.K., Krylov V.V. The prophylaxis and treatment of various complications at patients with spinal trauma (part 1). Neyrokhirurgiya = Russian Journal of Neurosurgery 2014;(4):75–86. (In Russ.).

6. Pawar A.Y., Biswas S.K. Postoperative spine infections. Asian Spine J 2016;10(1):176–83. DOI: 10.4184/asj.2016.10.1.176.

7. Chaudhary S.B., Vives M.J., Basra S.K., Reiter M.F. Postoperative spinal wound infections and postprocedural diskitis. J Spinal Cord Med 2007;30(5):441–51. DOI: 10.1080/10790268.2007.11753476.

8. Parchi P.D., Evangelisti G., Andreani L. et al. Postoperative spine infections. Orthop Rev (Pavia) 2015;7(3):5900. DOI: 10.4081/or.2015.5900.

9. Nahhas C.R., Hu K., Mehta A.I. Incidence and risk factors of wound complications in long segment instrumented thoracolumbar spinal fusions: a retrospective study. J Spine Surg 2018;4(2):233–40. DOI: 10.21037/jss.2018.05.11.

10. Dowdell J., Brochin R., Kim J. et al. Postoperative spine infection: diagnosis and management. Global Spine J 2018;8(4 Suppl):37S–43S. DOI: 10.1177/2192568217745512.

11. Blood A.G., Sandoval M.F., Burger E., Halverson-Carpenter K. Risk and protective factors associated with surgical infections among spine patients. Surg Infect (Larchmt) 2017;18(3):234–49. DOI: 10.1089/sur.2016.183.

12. Klein J.D., Hey L.A., Yu C.S. et al. Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine (Phila Pa 1976) 1996;21(22):2676–82. DOI: 10.1097/00007632-199611150-00018.

13. Rao S.B., Vasquez G., Harrop J. et al. Risk factors for surgical site infections following spinal fusion procedures: a case-control study. Clin Infect Dis 2011;53(7):686–92. DOI: 10.1093/cid/cir506.

14. Blam O.G., Vaccaro A.R., Vanichkachorn J.S. et al. Risk factors for surgical site infection in the patient with spinal injury. Spine (Phila Pa 1976) 2003;28(13):1475–80. DOI: 10.1097/01.BRS.0000067109.23914.0A.

15. Simpson J.M., Silveri C.P., Balderston R.A. et al. The results of operations on the lumbar spine in patients who have diabetes mellitus. J Bone Joint Surg Am 1993;75(12):1823–9. DOI: 10.2106/00004623-199312000-00013.

16. Ohya J., Oshima Y., Chikuda H. et al. Does the microendoscopic technique reduce mortality and major complications in patients undergoing lumbar discectomy? A propensity score-matched analysis using a nationwide administrative database. Neurosurg Focus 2016;40(2):E5. DOI: 10.3171/2015.10.FOCUS15479.

17. Oichi T., Oshima Y., Chikuda H. et al. In-hospital complication rate following microendoscopic versus open lumbar laminectomy: a propensity score-matched analysis. Spine J 2018;18(10):1815–21. DOI: 10.1016/j.spinee.2018.03.010.

18. Hollenbeck B.L., McGuire K.J., White A.P. et al. Invasiveness index as a predictor of surgical site infection after spinal fusion, revision fusion, or laminectomy. Infect Control Hosp Epidemiol 2017;38(1):11–7. DOI: 10.1017/ice.2016.244.

19. Chahoud J., Kanafani Z., Kanj S.S. Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. Front Med (Lausanne) 2014;1:7. DOI: 10.3389/fmed.2014.00007.

20. Ballard M.R., Miller N.H., Nyquist A.-C. et al. A multidisciplinary approach improves infection rates in pediatric spine surgery. J Pediatr Orthop 2012;32(3):266–70. DOI: 10.1097/bpo.0b013e31824b29c1.

21. Christodoulou A.G., Givissis P., Symeonidis P.D. et al. Reduction of postoperative spinal infections based on an etiologic protocol. Clin Orthop Relat Res 2006;444:107–13. DOI: 10.1097/01.blo.0000201174.10506.cc.


Review

For citations:


Grin A.A., Kaykov A.K., Kordonskiy A.Yu., Karanadze V.A., Levina O.A., Popkova L.V. Results of using the infection avoidance Protocol for postoperative wounds in spinal surgery. Russian journal of neurosurgery. 2020;22(3):51-56. (In Russ.) https://doi.org/10.17650/1683-3295-2020-22-3-51-56

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ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)
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