Volume 10, Issue 4 (11-2023)
JROS 2023, 10(4): 225-230 |
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Mahdavi S M, Behjat M, Mirzaei Tirabadi N, Parvandi A, Karimpoor A. Surgical Site Infection in Spinal cord Surgery: The Enhanced and Standard Protocols of Antibiotic Prophylaxis. JROS 2023; 10 (4) :225-230
URL: http://jros.iums.ac.ir/article-1-2268-en.html
URL: http://jros.iums.ac.ir/article-1-2268-en.html
1- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract: (140 Views)
Background: Surgical site infection (SSI) is a devastating complication of spinal surgery, and proper prevention is key to the success of these surgeries. Any incidence of SSI can increase the cost of care by up to four times that of primary spinal surgery. The use of prophylactic antibiotics to reduce SSI has been reported in studies.
Objectives: This study aims to compare the incidence of SSI in spine surgery patients receiving antibiotic prophylaxis based on the common protocol (1 g cefazolin plus 80 mg gentamicin) and upgraded protocol (1 g vancomycin plus 120 mg gentamicin).
Methods: This cohort study included patients who underwent spinal cord surgery at our center between 2019 and 2021. These patients were randomly assigned to two groups for prophylaxis: one group received antibiotics based on the routine protocol, and the other group received antibiotics according to the new protocol. All patients were evaluated for SSI two weeks after surgery.
Results: A total of 80 patients underwent spinal cord surgery, with 40 patients in each group (upgraded protocol and common protocol). The sex distribution was equal, with 20 men and 20 women in each group. The mean age of patients in the upgraded protocol group was 38.1±21.2 years, while in the common protocol group, it was 38.2±20.8 years, showing no significant difference. No significant relationship was observed between the patient’s sex and age with SSI. Among the patients in the common protocol group, four (10%) developed SSI. In contrast, in the upgraded protocol group, only one patient (2.5%) had a positive culture infection, and one patient (2.5%) had a hostile culture. The difference in SSI between the two groups following the upgraded and common protocols was statistically significant.
Conclusion: The study found that patients in the upgraded protocol group had significantly lower SSI rates than patients in the standard protocol group. Factors, such as diabetes mellitus, increased length of ICU stay, and urinary catheterization were identified as influencing SSI. However, age, sex, corticosteroid use, smoking, emergency or elective surgery, bleeding volume, chemotherapy and radiotherapy, and dura opening were not associated with SSI.
Objectives: This study aims to compare the incidence of SSI in spine surgery patients receiving antibiotic prophylaxis based on the common protocol (1 g cefazolin plus 80 mg gentamicin) and upgraded protocol (1 g vancomycin plus 120 mg gentamicin).
Methods: This cohort study included patients who underwent spinal cord surgery at our center between 2019 and 2021. These patients were randomly assigned to two groups for prophylaxis: one group received antibiotics based on the routine protocol, and the other group received antibiotics according to the new protocol. All patients were evaluated for SSI two weeks after surgery.
Results: A total of 80 patients underwent spinal cord surgery, with 40 patients in each group (upgraded protocol and common protocol). The sex distribution was equal, with 20 men and 20 women in each group. The mean age of patients in the upgraded protocol group was 38.1±21.2 years, while in the common protocol group, it was 38.2±20.8 years, showing no significant difference. No significant relationship was observed between the patient’s sex and age with SSI. Among the patients in the common protocol group, four (10%) developed SSI. In contrast, in the upgraded protocol group, only one patient (2.5%) had a positive culture infection, and one patient (2.5%) had a hostile culture. The difference in SSI between the two groups following the upgraded and common protocols was statistically significant.
Conclusion: The study found that patients in the upgraded protocol group had significantly lower SSI rates than patients in the standard protocol group. Factors, such as diabetes mellitus, increased length of ICU stay, and urinary catheterization were identified as influencing SSI. However, age, sex, corticosteroid use, smoking, emergency or elective surgery, bleeding volume, chemotherapy and radiotherapy, and dura opening were not associated with SSI.
Type of Study: Research Article |
Subject:
Spine surgery
Received: 2022/01/4 | Accepted: 2023/01/7 | Published: 2023/11/1
Received: 2022/01/4 | Accepted: 2023/01/7 | Published: 2023/11/1
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