title: Which method is the most effective for preventing postoperative infection in spinal surgery?
abstract: BACKGROUND
  Several methods have been used to reduce the infection rate in spinal surgeries with instrumentation.
  
  
  OBJECTIVE
  Which method is the most effective for preventing postoperative infection?
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Our study suggests that rifamycin application to the surgical area in spinal operations with instrumentation is an effective method to prevent S. aureus infections.
authors.affiliation: Department of Neurosurgery, Gaziosmanpasa University, Tokat, Turkey. eroloksuz@yahoo.com.|, Kaşıkcıbagları m. Ahmet Yesevi c., 8. Sok. No: 3, 60000, Merkez, Tokat, Turkey. eroloksuz@yahoo.com.
authors.forename: Erol
authors.initials: E
authors.lastname: Oksuz
authors.affiliation: Department of Neurosurgery, Gaziosmanpasa University, Tokat, Turkey.
authors.forename: Fatih Ersay
authors.initials: FE
authors.lastname: Deniz
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University, Tokat, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Gunal
authors.affiliation: Department of Neurosurgery, Gaziosmanpasa University, Tokat, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Demir
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpasa University, Tokat, Turkey.
authors.forename: Sener
authors.initials: S
authors.lastname: Barut
authors.affiliation: Department of Pathology, Gaziosmanpasa University, Tokat, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Markoc
authors.affiliation: Department of Statistics, Sakarya University, Sakarya, Turkey.
authors.forename: Unal
authors.initials: U
authors.lastname: Erkorkmaz
mesh_terms: D000818:Animals; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013131:Spine / Q000601:surgery*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D014025:Titanium
chemical_list: D014025:Titanium
keywords: Infection; Instrumentation; Rifamycin; Spinal surgery; Staphylococcus aureus