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Can hyperbaric oxygen be used to prevent deep infections in neuro-muscular scoliosis surgery?

Inanmaz ME, Kose KC, Isik C, Atmaca H, Basar H - BMC Surg (2014)

Bottom Line: The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery.The use of HBO was found to significantly decrease the incidence of postoperative infections in neuromuscular scoliosis patients.In this study we found that hyperbaric oxygen has a possibility to reduce the rate of post-surgical deep infections in complex spine deformity in high risk neuromuscular patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, Sakarya University Faculty of Medicine, Sakarya Universitesi Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, Sakarya, Turkey. erkaninanmaz@yahoo.com.

ABSTRACT

Background: The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery. Hyperbaric oxygen has been used as a supplement to treat postsurgical infections. Our aim was to determine beneficiary effects of hyperbaric oxygen treatment in terms of prevention of postoperative deep infection in this specific group of patients in a retrospective study.

Methods: Forty two neuromuscular scoliosis cases, operated between 2006-2011 were retrospectively reviewed. Patients who had presence of scoliosis and/or kyphosis in addition to cerebral palsy or myelomeningocele, postoperative follow-up >1 year and posterior only surgery were the subjects of this study. Eighteen patients formed the Hyperbaric oxygen prophylaxis (P-HBO) group and 24, the control group. The P-HBO group received 30 sessions of HBO and standard antibiotic prophylaxis postoperative, and the control group (received standard antibiotic prophylaxis).

Results: In the P-HBO group of 18 patients, the etiology was cerebral palsy in 13 and myelomeningocele in 5 cases with a mean age of 16.7 (11-27 yrs). The average follow-up was 20.4 months (12-36mo). The etiology of patients in the control group was cerebral palsy in 17, and myelomeningocele in 7 cases. The average age was 15.3 years (8-32 yrs). The average follow-up was 38.7 months (18-66mo). The overall incidence of infection in the whole study group was 11.9% (5/42). The infection rate in the P-HBO and the control group were 5.5% (1/18), and 16.6% (4/24) respectively. The use of HBO was found to significantly decrease the incidence of postoperative infections in neuromuscular scoliosis patients.

Conclusion: In this study we found that hyperbaric oxygen has a possibility to reduce the rate of post-surgical deep infections in complex spine deformity in high risk neuromuscular patients.

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Related in: MedlinePlus

A-14-year-old male patient with congenital kyphosis due to meningomyelocele. a: lateral and b: posterior view of the patient showing infected skin ulcers at the apex of the deformity and patient was predicted as high risk for infection c: The wound at postoperative day 1. Prophylactic HBO was started after surgery. d: Lateral and e: posterior clinical presentation of patient at postoperative 24th month. Written informed consent was obtained from the patient for publication of Figure 1 images.
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Fig1: A-14-year-old male patient with congenital kyphosis due to meningomyelocele. a: lateral and b: posterior view of the patient showing infected skin ulcers at the apex of the deformity and patient was predicted as high risk for infection c: The wound at postoperative day 1. Prophylactic HBO was started after surgery. d: Lateral and e: posterior clinical presentation of patient at postoperative 24th month. Written informed consent was obtained from the patient for publication of Figure 1 images.

Mentions: One patient in the P-HBO group had mild mental retardation, as compared with two in the control group. Four patients in the P-HBO and five in the control group had prior back surgery (closure of meningomyelocele in the newborn period). There were insufficient data available to compare nutrition markers and previous urinary tract infections. Three meningocele patients had decubiti on the surgical area (Two in the P-HBO (Figure 1) and one in the control group).Table 1


Can hyperbaric oxygen be used to prevent deep infections in neuro-muscular scoliosis surgery?

Inanmaz ME, Kose KC, Isik C, Atmaca H, Basar H - BMC Surg (2014)

A-14-year-old male patient with congenital kyphosis due to meningomyelocele. a: lateral and b: posterior view of the patient showing infected skin ulcers at the apex of the deformity and patient was predicted as high risk for infection c: The wound at postoperative day 1. Prophylactic HBO was started after surgery. d: Lateral and e: posterior clinical presentation of patient at postoperative 24th month. Written informed consent was obtained from the patient for publication of Figure 1 images.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4233033&req=5

Fig1: A-14-year-old male patient with congenital kyphosis due to meningomyelocele. a: lateral and b: posterior view of the patient showing infected skin ulcers at the apex of the deformity and patient was predicted as high risk for infection c: The wound at postoperative day 1. Prophylactic HBO was started after surgery. d: Lateral and e: posterior clinical presentation of patient at postoperative 24th month. Written informed consent was obtained from the patient for publication of Figure 1 images.
Mentions: One patient in the P-HBO group had mild mental retardation, as compared with two in the control group. Four patients in the P-HBO and five in the control group had prior back surgery (closure of meningomyelocele in the newborn period). There were insufficient data available to compare nutrition markers and previous urinary tract infections. Three meningocele patients had decubiti on the surgical area (Two in the P-HBO (Figure 1) and one in the control group).Table 1

Bottom Line: The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery.The use of HBO was found to significantly decrease the incidence of postoperative infections in neuromuscular scoliosis patients.In this study we found that hyperbaric oxygen has a possibility to reduce the rate of post-surgical deep infections in complex spine deformity in high risk neuromuscular patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, Sakarya University Faculty of Medicine, Sakarya Universitesi Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, Sakarya, Turkey. erkaninanmaz@yahoo.com.

ABSTRACT

Background: The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery. Hyperbaric oxygen has been used as a supplement to treat postsurgical infections. Our aim was to determine beneficiary effects of hyperbaric oxygen treatment in terms of prevention of postoperative deep infection in this specific group of patients in a retrospective study.

Methods: Forty two neuromuscular scoliosis cases, operated between 2006-2011 were retrospectively reviewed. Patients who had presence of scoliosis and/or kyphosis in addition to cerebral palsy or myelomeningocele, postoperative follow-up >1 year and posterior only surgery were the subjects of this study. Eighteen patients formed the Hyperbaric oxygen prophylaxis (P-HBO) group and 24, the control group. The P-HBO group received 30 sessions of HBO and standard antibiotic prophylaxis postoperative, and the control group (received standard antibiotic prophylaxis).

Results: In the P-HBO group of 18 patients, the etiology was cerebral palsy in 13 and myelomeningocele in 5 cases with a mean age of 16.7 (11-27 yrs). The average follow-up was 20.4 months (12-36mo). The etiology of patients in the control group was cerebral palsy in 17, and myelomeningocele in 7 cases. The average age was 15.3 years (8-32 yrs). The average follow-up was 38.7 months (18-66mo). The overall incidence of infection in the whole study group was 11.9% (5/42). The infection rate in the P-HBO and the control group were 5.5% (1/18), and 16.6% (4/24) respectively. The use of HBO was found to significantly decrease the incidence of postoperative infections in neuromuscular scoliosis patients.

Conclusion: In this study we found that hyperbaric oxygen has a possibility to reduce the rate of post-surgical deep infections in complex spine deformity in high risk neuromuscular patients.

Show MeSH
Related in: MedlinePlus