Abstract
Surgical site infection (SSI) is a significant complication after spinal surgery and is associated with increased hospital length of stay, high healthcare costs, and poor patient outcomes. Accurate identification of risk factors is essential to develop strategies to prevent wound infections. The aim of this prospective multicenter study was to determine the independent factors associated with SSI in posterior lumbar surgeries without fusion (laminectomy and/or herniotomy) for degenerative diseases in adult patients. From July 2010 to June 2014, we conducted a prospective multicenter surveillance study in adult patients who developed SSI after undergoing lumbar laminectomy and/or discectomy in ten participating hospitals. Detailed patient and operative characteristics were prospectively recorded using a standardized data collection format. SSI was based on the Centers for Disease Control and Prevention definition. A total of 4027 consecutive adult patients were enrolled, of which 26 (0.65%) developed postoperative SSI. Multivariate regression analysis indicated two independent factors. An operating time >2 h (P = 0.0095) was a statistically significant independent risk factor, whereas endoscopic tubular surgery (P = 0.040) was a significant independent protective factor. Identification of these associated factors may contribute to surgeons’ awareness of the risk factors for SSI and could help counsel the patients on the risks associated with lumbar laminectomy and/or discectomy. Furthermore, this study’s findings could be used to develop protocols to decrease SSI risk. To the best of our knowledge, this is the first prospective multicenter study that identified endoscopic tubular surgery as an independent protective factor against SSI after lumbar posterior surgery without fusion.
Highlights
Surgical site infection (SSI) after spinal surgery, which occurs in 0.7–12% of patients, is one of the most serious complications and could result in high morbidity, high mortality, poor operative outcomes, and increased healthcare costs [1, 2]
From July 2010 to June 2014, a prospective surveillance study of SSI following posterior lumbar surgeries without fusion for degenerative diseases in adult patients was conducted in ten participating Japanese hospitals
With respect to the demographic characteristics, male sex, use of an endoscope, and an operative time >2 h were significantly associated with SSI (P < 0.05), while a higher body mass index, ASA score 2, smoking, steroid use, laminectomy, and revision surgery were correlated (P < 0.20) with SSI
Summary
Surgical site infection (SSI) after spinal surgery, which occurs in 0.7–12% of patients, is one of the most serious complications and could result in high morbidity, high mortality, poor operative outcomes, and increased healthcare costs [1, 2]. A variety of risk factors for SSI after spinal surgery have been previously identified to prevent this significant complication These risk factors include advanced age [3], male sex [4], obesity [5, 6], previous spinal surgery [5], malnutrition [3], diabetes [5,6,7], smoking [5], spinal trauma [8, 9], corticosteroid use [5, 10], spinal instrumentation [11], posterior surgical approach [2], tumor resection [2], surgery involving sacrum [11], dural tear [12], conventional open spinal surgery instead of endoscopic tubular surgery [13, 14], increased estimated blood loss [7], and prolonged operating time [11, 15]. Standardized, hospital-based, multicenter surveillance methods utilizing the standard definition of SSI have been considered useful in determing risk factors [16,17,18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
