Abstract
Objective. To analyze the current level of early postoperative septic complications in a large retrospective series of patients with idiopathic scoliosis operated in the same clinic. Material and Methods . The single-center retrospective database of 1973 patients who underwent surgical correction of idiopathic scoliosis with corrective segmental 3rd generation instrumentation during 1996-2013 was studied. In all patients, antibiotic prophylaxis was started 30 minutes before incision and lasted up to 72 hours after surgery. Cefazolin in age-specific dosage variances was used as antibiotic. Drainage of the area of surgical intervention was performed within two days after surgery. Results . Surgical site infection occurred in 12 cases (0.6 %) within 90 days after surgery. Suppuration developed only in the area of posterior approach to the spine. The most common pathogen was S. epidermidis isolated in 68.0 % of cases. Implants and the achieved correction of spinal deformity were saved in 10 (83.0 %) patients. Conclusion . Prevention of postoperative infections in surgery of idiopathic scoliosis is the most important task. It is necessary to carry out an early revision and debridement of the wound and strive to maintain implants if they are stable.
Highlights
To analyze the current level of early postoperative septic complications in a large retrospective series of patients with idiopathic scoliosis operated in the same clinic
Drainage of the area of surgical intervention was performed within two days after surgery
Surgical site infection occurred in 12 cases (0.6 %) within 90 days after surgery
Summary
Анализ текущего уровня ранних послеоперационных гнойных осложнений в большой ретроспективной серии пациентов с идиопатическим сколиозом, оперированных в одной клинике. Исследована одноцентровая ретроспективная база данных 1973 пациентов, перенесших хирургическую коррекцию идиопатического сколиоза с использованием корригирующего сегментарного инструментария III поколения в 1996–2013 гг. Всем пациентам за 30 мин до разреза начинали антибиотикопрофилактику, которую продолжали до 72 ч после операции. Дренирование области оперативного вмешательства осуществляли в течение двух суток после операции. В 12 (0,6 %) случаях возникла инфекция в области хирургического вмешательства в течение первых 90 дней после операции. Нагноение развивалось только в области дорсального доступа к позвоночнику. У 10 (83,0 %) пациентов удалось сохранить имплантат и достигнутую коррекцию деформации позвоночника. Предотвращение послеоперационных инфекций в хирургии идиопатического сколиоза является важнейшей задачей. Ключевые слова: идиопатический сколиоз, инфекция в области хирургического вмешательства, коррекция деформации.
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