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Published in: European Spine Journal 4/2016

01-04-2016 | Original Article

Which method is the most effective for preventing postoperative infection in spinal surgery?

Authors: Erol Oksuz, Fatih Ersay Deniz, Ozgur Gunal, Ozgur Demir, Sener Barut, Fatma Markoc, Unal Erkorkmaz

Published in: European Spine Journal | Issue 4/2016

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Abstract

Background

Several methods have been used to reduce the infection rate in spinal surgeries with instrumentation.

Purpose

Which method is the most effective for preventing postoperative infection?

Study design

Basic science, animal model.

Objective

In the present study, the efficiency of antibiotic prophylaxis, silver-plated screws, and local rifamycin application to the surgical site was investigated in an experimental animal model. Staphylococcus aureus was used as the pathogen.

Methods

Fifty 6-month-old female Wistar albino rats were used. The animals were randomly numbered and divided into five groups of ten rats each (Group 1, control group; Group 2, titanium screw and S. aureus inoculation; Group 3, titanium screw, 0.1 ml rifamycin application to the surgical area, and bacterial inoculation; Group 4, titanium screw, single preoperative dose of IM cefazolin, and bacterial inoculation; Group 5, silver-plated screw and bacterial inoculation). Titanium micro-screws were placed into the pedicles. The control group received a sterile isotonic solution, and the other four groups received bacterial suspensions containing S. aureus. The animals were killed 15 days later.

Results

Intensive S. aureus growth was observed in all tissue and screw samples from Group 2. The results for Group 3 were similar to those for Group 1, no growth was observed in the screw cultures. Intensive growth was observed in the five screw samples in Group 4 and in the eight samples in Group 5.

Conclusion

Our study suggests that rifamycin application to the surgical area in spinal operations with instrumentation is an effective method to prevent S. aureus infections.
Literature
1.
go back to reference Fang A, Hu SS, Endres N, Bradford DS (2005) Risk factors for infection after spinal surgery. Spine 30:1460–1465CrossRefPubMed Fang A, Hu SS, Endres N, Bradford DS (2005) Risk factors for infection after spinal surgery. Spine 30:1460–1465CrossRefPubMed
2.
go back to reference Lim MR, Lee JY, Vaccaro AR (2006) Surgical infections in the traumatized spine. Clin Orthop Relat Res 444:114–119CrossRefPubMed Lim MR, Lee JY, Vaccaro AR (2006) Surgical infections in the traumatized spine. Clin Orthop Relat Res 444:114–119CrossRefPubMed
3.
go back to reference Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR (1992) Postoperative posterior spinal wound infections. Clin Orthop Relat Res 284:99–108PubMed Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR (1992) Postoperative posterior spinal wound infections. Clin Orthop Relat Res 284:99–108PubMed
4.
go back to reference Weinstein MA, McCabe JP, Cammisa FP Jr (2000) Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord 13(5):422–426CrossRefPubMed Weinstein MA, McCabe JP, Cammisa FP Jr (2000) Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord 13(5):422–426CrossRefPubMed
5.
go back to reference Hodges SD, Humphreys SC, Egk JC, Covington LA, Kurzynske NG (1998) Low postoperative infection rates with instrumented lumbar fusion. South Med J 91:1132–1136CrossRefPubMed Hodges SD, Humphreys SC, Egk JC, Covington LA, Kurzynske NG (1998) Low postoperative infection rates with instrumented lumbar fusion. South Med J 91:1132–1136CrossRefPubMed
6.
go back to reference Silber JS, Anderson DG, Vaccaro AR, Anderson PA, McCormick P (2002) Management of postprocedural discitis. Spine J 2(4):279–287CrossRefPubMed Silber JS, Anderson DG, Vaccaro AR, Anderson PA, McCormick P (2002) Management of postprocedural discitis. Spine J 2(4):279–287CrossRefPubMed
7.
go back to reference Barker FG (2002) Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis. Neurosurgery 51:391–401PubMed Barker FG (2002) Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis. Neurosurgery 51:391–401PubMed
8.
go back to reference Hellbusch LC, Helzer-Julin M, Doran SE et al (2008) Single-dose vs multiple-dose antibiotic prophylaxis in instrumented lumbar fusion—a prospective study. Surg Neurol 70(6):622–627 (discussion 627)CrossRefPubMed Hellbusch LC, Helzer-Julin M, Doran SE et al (2008) Single-dose vs multiple-dose antibiotic prophylaxis in instrumented lumbar fusion—a prospective study. Surg Neurol 70(6):622–627 (discussion 627)CrossRefPubMed
9.
go back to reference Van Middendorp JJ, Pull ter Gunne AF, Schuetz M et al (2012) A methodological systematic review on surgical site infections following spinal surgery. Spine 37(24):2034–2045CrossRefPubMed Van Middendorp JJ, Pull ter Gunne AF, Schuetz M et al (2012) A methodological systematic review on surgical site infections following spinal surgery. Spine 37(24):2034–2045CrossRefPubMed
10.
go back to reference Ofluoglu EA, Zileli M, Aydin D, Baris YS et al (2007) Implant-related infection model in rat spine. Arch Orthop Trauma Surg 127:391–396CrossRefPubMed Ofluoglu EA, Zileli M, Aydin D, Baris YS et al (2007) Implant-related infection model in rat spine. Arch Orthop Trauma Surg 127:391–396CrossRefPubMed
11.
go back to reference Watters WC, Baisden J, Bono CM et al (2009) Antibiotic prophylaxis in spine surgery: an evidence-based clinical guideline for the use of prophylactic antibiotics in spine surgery. Spine J 9:142–146CrossRefPubMed Watters WC, Baisden J, Bono CM et al (2009) Antibiotic prophylaxis in spine surgery: an evidence-based clinical guideline for the use of prophylactic antibiotics in spine surgery. Spine J 9:142–146CrossRefPubMed
12.
go back to reference Walters R, Rahmat R, Shimamura Y, Fraser R, Moore R (2006) Prophylactic cephazolin to prevent discitis in an ovine model. Spine 31(4):391–396CrossRefPubMed Walters R, Rahmat R, Shimamura Y, Fraser R, Moore R (2006) Prophylactic cephazolin to prevent discitis in an ovine model. Spine 31(4):391–396CrossRefPubMed
13.
go back to reference Calfee DP (2010) Rifamycins. In: Mandell GL, Bennett JE, Dolin R (eds) Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 7th edn. Elsevier, Philadelphia, pp 403–418CrossRef Calfee DP (2010) Rifamycins. In: Mandell GL, Bennett JE, Dolin R (eds) Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 7th edn. Elsevier, Philadelphia, pp 403–418CrossRef
14.
go back to reference Senneville E, Joulie D, Legout L et al (2011) Outcome and predictors of treatment failure in total hip/knee prosthetic joint infections due to Staphylococcus aureus. Clin Infect Dis 53:334–340CrossRefPubMedPubMedCentral Senneville E, Joulie D, Legout L et al (2011) Outcome and predictors of treatment failure in total hip/knee prosthetic joint infections due to Staphylococcus aureus. Clin Infect Dis 53:334–340CrossRefPubMedPubMedCentral
15.
go back to reference Muttaiyah S, Ritchie S, John S, Mee E, Roberts S (2010) Efficacy of antibiotic-impregnated external ventricular drain catheters. J Clin Neurosci 17:296–298CrossRefPubMed Muttaiyah S, Ritchie S, John S, Mee E, Roberts S (2010) Efficacy of antibiotic-impregnated external ventricular drain catheters. J Clin Neurosci 17:296–298CrossRefPubMed
16.
go back to reference Secinti KD, Ayten M, Kahilogullari G, Kaygusuz G, Ugur HC, Attar A (2008) Antibacterial effects of electrically activated vertebral implants. J Clin Neurosc 15:434–439CrossRef Secinti KD, Ayten M, Kahilogullari G, Kaygusuz G, Ugur HC, Attar A (2008) Antibacterial effects of electrically activated vertebral implants. J Clin Neurosc 15:434–439CrossRef
Metadata
Title
Which method is the most effective for preventing postoperative infection in spinal surgery?
Authors
Erol Oksuz
Fatih Ersay Deniz
Ozgur Gunal
Ozgur Demir
Sener Barut
Fatma Markoc
Unal Erkorkmaz
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 4/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-3941-y

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