title: Local irrigation of the surgical field with antibiotics in the end of procedure reduces the infection rate in herniated lumbar disc surgery.
abstract: BACKGROUND
  Reported rate of infections after lumbar discectomy is 1%-15 %. This complication may result in disability or even the death.
  
  
  OBJECTIVE
  The aim of the study is to assess the rate of infection associated with lumbar discectomies when combined systemic and local antibiotic prophylaxis was employed.
  
  
  METHODS
  In this retrospective study we analyzed all patients operated for herniated lumbar disc from 2009 -2012 in our institute. Beside of receiving systemic prophylaxis with 2g of Cefazoline, all patients had their operative field irrigated at the end of operation with Amikacin sulfate injection. Wound was considered infected when local and systemic signs of infection were revealed and were associated with elevated ESR, leukocytosis and elevated CRP. Assessment of infection is done by neurosurgeon during the hospitalization and later at outpatient's clinic along postoperative course of three months.
  
  
  RESULTS
  A total of 604 patients were operated, of those 285 patients (47.2 %) females and 319 males (52.8 %), 12 patients were operated on two levels (1.98 %). Average patient age was 32.5 years (range 20-65 years) Localization of herniated disc was: in L/2-L/3 20 patients or 3.3 %, the L/3-L/4 level 42 patients or 7 % , the L/4 -L /5 262 patients or 43.3 % at the level L/V- S/1 280 patients or 46.3 %. Three patients (0.49%) developed wound infection, two of them superficial infection only with local signs: local pain, redness and leakage. They were treated with oral antibiotics. One with deep wound infection. He presented with local and systemic signs and treated with i.v antibiotics. All the cultures from wound swab revealed staphylococcus aureus.
  
  
  CONCLUSIONS
  Prophylaxis with systemic antibiotic (Cefazoline 2.0) intravenous administration 30 minutes before the incision and irrigation of operative field with local antibiotic Amikacine sulfate at the end of procedure reduces the infection rate in patients operated for herniated lumbar disc when compared with systemic antibiotic prophylaxis only.
authors: Clinic of Neurosurgery, University Clinical Centre of Kosova, Prishtina.
authors: Armend
authors: A
authors: Kërveshi
authors: Clinic of Neurosurgery, University Clinical Centre of Kosova, Prishtina.
authors: Nehat
authors: N
authors: Halili
authors: Clinic of Neurosurgery, University Clinical Centre of Kosova, Prishtina.
authors: Bujar
authors: B
authors: Kastrati
authors: Clinic of Neurosurgery, University Clinical Centre of Kosova, Prishtina.
authors: Faik
authors: F
authors: Qosja
authors: Faculty of Medicine, Prishtina University, Prishtina, Republic of Kosova.
authors: Serbeze
authors: S
authors: Kabashi
authors: Faculty of Medicine, Prishtina University, Prishtina, Republic of Kosova ; National Institute of Public Health of Kosova.
authors: Sefedin
authors: S
authors: Muçaj
keywords: Lumbar discectomy; infection; local space irrigation with antibiotics; systemic antibiotic prophylaxis