The incidence and risk factors for surgical site infection after clean spinal operations: A prospective cohort study and review of the literature.
BACKGROUND
Postoperative infection is one of the most common complications after spine surgeries. In our study, surgical site infection (SSI) is described as; superficial (i.e., skin and subcutaneous tissues) and deep (i.e., fascia and muscles) infections occurring in the short term (i.e., 1-month) after spine surgeries (Centers for Disease Control and Prevention definition 81.00-81.08). To detect the risk factors for the occurrence of such a complication, studies require a large number of patients, a high quality of data and adequate analysis. In this study, we prospectively enrolled 987 patients undergoing spinal surgery over a 3 years period.


METHODS
From November 2010 to November 2013, 987 patients had a variety of spinal operations that included; disc herniation, spinal stenosis, spondylolisthesis, fracture-dislocations, spine and spinal cord tumors, and syringomyelia. Patients under the age of 10, those with a recent history of infection and antibiotherapy, and patients with immunodeficiency disorders were excluded.


RESULTS
Of the 987 spine procedures performed, 27 (2.73%) developed postoperative infections. Multi-variant data analysis indicated that multiple factors correlated with an increased risk of SSI in descending order; trauma, a past history of diabetes, smoking, being confined to bed, in the perioperative period, mean blood sugar levels above 120 mg/dl, longer lengths of incisions, and longer hospital stay.


CONCLUSIONS
Considering the preventable nature of most of the factors contributing to SSI, it should be possible to reduce these complications.
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Saeed
S
Saeedinia
Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohsen
M
Nouri
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Amir
A
Azarhomayoun
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Hamed
H
Hanif
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Abolghasem
A
Mortazavi
Department of Neurosurgery, Razi Hospital, Zahedan University of Medical Sciences, Saravan, Iran.
Parisa
P
Bahramian
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Kourosh Karimi
KK
Yarandi
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Abbas
A
Amirjamshidi
Diabetes; discectomy; spine fusion; spine trauma; surgical site infection