Efficacy of integuseal for surgical skin preparation in children and adolescents undergoing scoliosis correction.
METHODS
Prospective randomized trial.


OBJECTIVE
To explore the use of a microbial sealant applied before the surgical incision to reduce surgical site infection in patients with scoliosis.


BACKGROUND
The incidence of superficial or deep infections is reported in 2 groups of patients treated for neuromuscular or adolescent idiopathic scoliosis. Statistical analysis aimed to compare the effect of the use of a cyanoacrylate microbial sealant on infection rate.


METHODS
From June 2010 to June 2011, 56 patients were prospectively enrolled in the study. Using a random number table, patients were assigned either to receive or not a sterile, film-forming cyanoacrylate liquid application (Integuseal). Epidemiological data and infection occurrence were compared in both groups.


RESULTS
Statistical analysis comparing patients with neuromuscular scoliosis and adolescent idiopathic scoliosis showed that patients with neuromuscular scoliosis had more fused levels, increased intraoperative bleeding, and longer intraoperative time. Six patients had early postoperative infections of the posterior approach, which included 3 deep and 3 superficial infections. Five infections occurred in patients treated with Integuseal. Outcome was favorable in 6 cases after local wound debridement and antibiotics. Nonparametric statistical tests (Fisher exact test) showed no significant correlation (P = 0.096) between early postoperative infection occurrence and the use of Integuseal.


CONCLUSIONS
Although microbial sealant may be a useful addition to a multimodal approach to minimize surgical site infection, there is currently insufficient evidence as to whether the use of microbial sealants reduces the risk of surgical site infection in patients undergoing scoliosis surgery.
Department of Pediatric Orthopaedics, Université Pierre et Marie Curie Paris 6, Armand Trousseau Hospital, Paris, France.
Eric
E
Dromzee
Quentin
Q
Tribot-Laspière
Manon
M
Bachy
Serge
S
Zakine
Pierre
P
Mary
Raphaël
R
Vialle
D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002648:Child; D003487:Cyanoacrylates / Q000627:therapeutic use*; D006801:Humans; D011183:Postoperative Complications / Q000382:microbiology / Q000517:prevention & control*; D011300:Preoperative Care; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*; D012867:Skin / Q000187:drug effects* / Q000382:microbiology; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D003487:Cyanoacrylates