Current concepts in perioperative care for the prevention of deep surgical site infections in elective spinal surgery.
BACKGROUND
Postoperative deep wound infections are the third most common reason for nosocomial infections after pneumonia and urinary tract infections. Deep wound infections lead to higher rates of morbidity and mortality and increased costs of treatment. Infection rates following spinal surgery are reported to lie between 1.9 and 10%. This study was carried out to prove whether a new internal concept for perioperative management could reduce the infection rates following spinal surgery.


METHODS
Based on the current literature we developed a concept for perioperative care in spinal surgery in order to prevent postoperative deep wound infections. We retrospectively compared infection rates of 2006 and 2007 after the implementation of our perioperative care concept in spinal surgery patients. Total annual operations were comparable.


RESULTS
After the introduction of our predominantly evidence-based concept of perioperative care for spinal surgery patients, we found a considerable decrease in infection rates from 0.6% in 2006 to 0% in 2007.


CONCLUSIONS
A new concept for perioperative care in spinal surgery for the prevention of deep wound infections was found to effectively reduce infection rates. Due to the limitations of our single-center retrospectively selected cohort, further research is necessary to support our results.
Meyer
D
D
Evangelisches Krankenhaus Oldenburg, Department of Neurosurgery, Steinweg 13-17, Oldenburg, Germany. dr.dirk.meyer@evangelischeskrankenhaus.de
Klarenbeek
R
R
Meyer
F
F
D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D003428:Cross Infection / Q000517:prevention & control; D017558:Elective Surgical Procedures; D019317:Evidence-Based Medicine; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome