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KMID : 0377220020270010070
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Medical Journal of Chosun Univercity
2002 Volume.27 No. 1 p.70 ~ p.77
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Analysis of Postoperative Spinal Wound Infections
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Lee Seung-Myung
Shin Ho
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Abstract
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Objectives : Postoperative spinal wound infection continues to be a source of frustration for patients and surgeons, and can lead to significant postoperative difficulties. The rate of spinal wound infections has not decreased during the past decades despite the introduction of new antibiotics.
Methods : Sixty-six patients, were reviewed, who developed postoperative spinal wound infection at Chosun University Hospital from January 1995 to August 2001. These patients (41 men, 25 women) were analyzed for preoperative risk factors, clinical presentation, treatment and outcome. These patients, with a mean age of 50.27 years (range 26-77), were treated for 45 deep and 7 superficial wound infections.
Result : The incidence of postoperative spinal infections increases with use of spinal instrumentation (Noninstrumented cases 18, instrumented cases 48) and posterior surgical approach (posterior approach 54 cases, anterior approach 12 cases). The patients who developed postoperative spinal wound infection were analyzed for the infection risk factors (RF) identified in individual patients preoperatively. Staphylococcus aureus was the most frequent cultured organism (39 of 66 cases). Of 66 patients, nine had infections involved with multiple organisms and two cases revealed fungal infection due to Candida. 61 patients were infection free at a minimum of 6 months follow-up.
Conclusion : Effective treatment of deep wound infection includes early diagnosis, prompt and aggressive surgical debridement, insertion of antibiotics-containing irrigation-suction systems for a mean of 6 days and parenteral antibiotics followed by oral antibiotics.
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KEYWORD
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Postoperative spinal wound infection, Preoperative risk factor, Irrigation-suction system
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