Limits...
Particular Features of Surgical Site Infection in Posterior Lumbar Interbody Fusion.

Kim JH, Ahn DK, Kim JW, Kim GW - Clin Orthop Surg (2015)

Bottom Line: The difference of incidence among three groups was significant (p = 0.002).The most common bacteria encountered were methicillin-resistant Staphylococcus epidermidis followed by methicillin-resistant S. aureus in incisional infections, and no growth followed by S. epidermidis in O/SI.Contamination of auto-local bone was presumed attributable to the progression of SSI.Irrigation of auto-local bone helped in the reduction of SSI.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.

ABSTRACT

Background: Previous reports have observed differences only in infection rates between posterolateral fusion and posterior lumbar interbody fusion (PLIF). There have been no reports that describe the particular features of surgical site infection (SSI) in PLIF. In this study, we endeavor to identify the distinguishing characteristics and risk factors of SSI in PLIF.

Methods: Our study undertook a review of a case series of an institute. Patients who had undergone PLIF consecutively in the author's hospital were reviewed. Two proactive procedures were introduced during the study period. One was irrigation of the autolocal bone, and the other was the intradiscal space irrigation with a nozzle. Infection rate and risk factors were analyzed. For subgroup analysis, the elapsed time to a diagnosis (ETD), clinical manifestations, hematologic findings, and causative bacteria were examined in patients with SSI.

Results: In a total of 1,831 cases, there were 30 cases of SSI (1.6%). Long operation time was an independent risk factor (p = 0.008), and local bone irrigation was an independent protective factor (p = 0.001). Two cases of referred SSI were included in the subgroup analysis. There were 6/32 (19%) superficial incisional infections (SII), 6/32 (19%) deep incisional infections (DII), and 20/32 (62%) organ/space infections (O/SI). The difference of incidence among three groups was significant (p = 0.002).The most common bacteria encountered were methicillin-resistant Staphylococcus epidermidis followed by methicillin-resistant S. aureus in incisional infections, and no growth followed by S. epidermidis in O/SI. ETD was 8.5 ± 2.3 days in SII, 8.7 ± 2.3 days in DII and 164.5 ± 131.1 days in O/SI (p = 0.013).

Conclusions: The rate of SSI in PLIF was 1.6%, with the most common type being O/SI. The causative bacteria of O/SI was of lower virulence than in the incisional infection, and thus diagnosis was delayed due to its latent and insidious feature. Contamination of auto-local bone was presumed attributable to the progression of SSI. Irrigation of auto-local bone helped in the reduction of SSI.

No MeSH data available.


Related in: MedlinePlus

Annual incidence of surgical site infection in posterior lumbar interbody fusions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553282&req=5

Figure 2: Annual incidence of surgical site infection in posterior lumbar interbody fusions.

Mentions: There were 2,347 PLIF cases during the study period. Of these, 516 cases were excluded due to ineligibility of medical records. Finally, 1,831 cases were included (Fig. 1). There were 1,322 cases of one segment, 387 cases of 2 segments, 96 cases of 3 segments, and 4 cases of 4 or more segments. A total of 30 cases developed SSI, the incidence being 1.6%. There was a significant difference in annual incidence (p = 0.008) (Fig. 2). Two additional procedures were added during the study period. Irrigation of local bone commenced from February 2007, and intradiscal irrigation with a nozzle began from January 2010. Two SSI cases were transferred from other hospitals. Classification was as follows: 19% (6/32) SII, 19% (6/32) DII, and 62% (20/32) O/SI (all were spondylitis cases) (Fig. 3). The incidence was significantly different (p = 0.002).


Particular Features of Surgical Site Infection in Posterior Lumbar Interbody Fusion.

Kim JH, Ahn DK, Kim JW, Kim GW - Clin Orthop Surg (2015)

Annual incidence of surgical site infection in posterior lumbar interbody fusions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553282&req=5

Figure 2: Annual incidence of surgical site infection in posterior lumbar interbody fusions.
Mentions: There were 2,347 PLIF cases during the study period. Of these, 516 cases were excluded due to ineligibility of medical records. Finally, 1,831 cases were included (Fig. 1). There were 1,322 cases of one segment, 387 cases of 2 segments, 96 cases of 3 segments, and 4 cases of 4 or more segments. A total of 30 cases developed SSI, the incidence being 1.6%. There was a significant difference in annual incidence (p = 0.008) (Fig. 2). Two additional procedures were added during the study period. Irrigation of local bone commenced from February 2007, and intradiscal irrigation with a nozzle began from January 2010. Two SSI cases were transferred from other hospitals. Classification was as follows: 19% (6/32) SII, 19% (6/32) DII, and 62% (20/32) O/SI (all were spondylitis cases) (Fig. 3). The incidence was significantly different (p = 0.002).

Bottom Line: The difference of incidence among three groups was significant (p = 0.002).The most common bacteria encountered were methicillin-resistant Staphylococcus epidermidis followed by methicillin-resistant S. aureus in incisional infections, and no growth followed by S. epidermidis in O/SI.Contamination of auto-local bone was presumed attributable to the progression of SSI.Irrigation of auto-local bone helped in the reduction of SSI.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.

ABSTRACT

Background: Previous reports have observed differences only in infection rates between posterolateral fusion and posterior lumbar interbody fusion (PLIF). There have been no reports that describe the particular features of surgical site infection (SSI) in PLIF. In this study, we endeavor to identify the distinguishing characteristics and risk factors of SSI in PLIF.

Methods: Our study undertook a review of a case series of an institute. Patients who had undergone PLIF consecutively in the author's hospital were reviewed. Two proactive procedures were introduced during the study period. One was irrigation of the autolocal bone, and the other was the intradiscal space irrigation with a nozzle. Infection rate and risk factors were analyzed. For subgroup analysis, the elapsed time to a diagnosis (ETD), clinical manifestations, hematologic findings, and causative bacteria were examined in patients with SSI.

Results: In a total of 1,831 cases, there were 30 cases of SSI (1.6%). Long operation time was an independent risk factor (p = 0.008), and local bone irrigation was an independent protective factor (p = 0.001). Two cases of referred SSI were included in the subgroup analysis. There were 6/32 (19%) superficial incisional infections (SII), 6/32 (19%) deep incisional infections (DII), and 20/32 (62%) organ/space infections (O/SI). The difference of incidence among three groups was significant (p = 0.002).The most common bacteria encountered were methicillin-resistant Staphylococcus epidermidis followed by methicillin-resistant S. aureus in incisional infections, and no growth followed by S. epidermidis in O/SI. ETD was 8.5 ± 2.3 days in SII, 8.7 ± 2.3 days in DII and 164.5 ± 131.1 days in O/SI (p = 0.013).

Conclusions: The rate of SSI in PLIF was 1.6%, with the most common type being O/SI. The causative bacteria of O/SI was of lower virulence than in the incisional infection, and thus diagnosis was delayed due to its latent and insidious feature. Contamination of auto-local bone was presumed attributable to the progression of SSI. Irrigation of auto-local bone helped in the reduction of SSI.

No MeSH data available.


Related in: MedlinePlus