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首页> 外文期刊>British journal of neurosurgery >Retrospective study of deep surgical site infections following spinal surgery and the effectiveness of continuous irrigation.
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Retrospective study of deep surgical site infections following spinal surgery and the effectiveness of continuous irrigation.

机译：脊柱手术后深部手术部位感染的回顾性研究以及连续冲洗的有效性。

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Surgical site infection (SSI) is an unfortunate and unpreventable complication of any surgical intervention including spinal surgery. Early deep SSI (EDSSI) after instrumented spinal fusion are particularly difficult to manage due to the implanted, and possibly infected, instrumentation. The purpose of this study is to retrospectively review patients who underwent spinal surgery, investigate the rate of EDSSI, identify patient-related and surgery-related risk factors and to assess the effectiveness of continuous indwelling irrigation on the eradication of these infections. A total of 814 patients (319 women and 495 men) who underwent spinal surgery were enrolled. Mean age at the initial surgery was 57.4 years old. Infections that penetrated the deep fascia within 1 month after the initial operation were considered as EDSSI. The rate of EDSSI, causal organisms, infection management and resolution were studied. Furthermore, we examined the patient-related and the operation-related risk factors. An overall incidence of EDSSI of 1.1% was found. In 177 patients with diabetes mellitus (DM), two patients (1.1%) developed EDSSI. In 28 patients receiving chronic haemodialysis (HD), two patients with infections (7.1%) were identified, which was statistically significantly greater than the other patient populations. Both operative time and intraoperative blood loss were significantly greater in patients with EDSSI than in non-infected patients. Furthermore, the rate of EDSSI in patients undergoing instrumented spinal fusion (3.8%) was significantly higher than that in the other patients. In the nine patients who developed EDSSI, the causal organisms were identified and treated by surgical debridement, antibiotic therapy and continuous indwelling surgical site irrigation. All infections resolved, and no recurrence has been observed at final follow-up. Removal of the instrumentation was required in only one patient. Based on our results, we believe that continuous surgical site irrigation is an effective adjunct in the surgical treatment for early SSI following spinal surgery.
机译：手术部位感染（SSI）是任何包括脊柱外科手术在内的外科手术的不幸和无法预防的并发症。由于植入的并且可能被感染的器械，在器械性脊柱融合术之后的早期深SSI（EDSSI）特别难以管理。这项研究的目的是回顾性回顾接受脊柱手术的患者，调查EDSSI的发生率，确定与患者相关和与手术相关的危险因素，并评估持续留置冲洗对根除这些感染的有效性。总共进行了814例脊柱外科手术的患者（319名女性和495名男性）。初次手术的平均年龄为57.4岁。初次手术后1个月内穿透深筋膜的感染被视为EDSSI。研究了EDSSI的发生率，病原菌，感染管理和解决方案。此外，我们检查了患者相关和手术相关的危险因素。发现EDSSI的总发生率为1.1％。在177例糖尿病（DM）患者中，两名患者（1.1％）患上了EDSSI。在接受慢性血液透析（HD）的28例患者中，确定了2例感染（7.1％），这在统计学上显着高于其他患者。与未感染的患者相比，EDSSI患者的手术时间和术中失血量均显着增加。此外，接受脊柱融合术的患者的EDSSI率（3.8％）显着高于其他患者。在9名发展为EDSSI的患者中，通过手术清创，抗生素治疗和持续留置手术部位冲洗确定了病因生物并进行了治疗。所有感染均已解决，在最终随访中未观察到复发。仅一名患者需要拆除器械。根据我们的结果，我们认为连续手术部位冲洗是脊柱手术后早期SSI手术治疗的有效辅助手段。

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