Antibiotic prophylaxis and routine management guidelines to minimize the occurrence of postoperative spinal infections

Abstract

The Pre-Lister era of surgery in the mid 19th century was complicated by infection in over 90% of cases, the result of which often led to significant widespread morbidity and mortality known as “hospitalism.” Ironically, the “laudable pus” was often welcomed as a natural sign of the healing process before it inevitably signified the development of gangrene, tetanus, erysipelas, septicemia, and other dreaded lethal consequences. 1 The principles of antiseptic and aseptic surgery,setforthbyListerinhismanuscriptdated1867,“On the Antiseptic Principle in the Practice of Surgery,” were based on preliminary work from Pasteur who described a microbial source for disease. Some of the techniques that are attributed to Lister’s principles of antiseptic surgery include carbolic acid sprays, soaking of suture materials, and hand washing; use of these principles alone reduced infection rates to approximately 10%. 2