title: Offset layered closure reduces deep wound infection in early-onset scoliosis surgery.
abstract: Deep wound infection is a common complication in early-onset scoliosis (EOS) surgery. Soft tissue technique has received less attention as a means to reduce infection. A retrospective review of 1170 EOS surgeries (single surgeon, institution) investigated the impact of offset layered closure (OLC) and soft tissue awareness. The introduction of OLC reduced deep infection from 3.0% in 99 surgeries to 0.37% in 1071. Logistic regression confirmed that OLC led to significantly lower odds of infection (P=0.007). This deep infection rate (0.37%) is more typical of elective surgery, providing a more optimistic view of infection in EOS surgery than generally reported.
authors.affiliation: Department of Orthopedic Surgery, Harvard Medical School, Division of Spine Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Grzywna
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Miller
authors.forename: Michael P
authors.initials: MP
authors.lastname: Glotzbecker
authors.forename: John B
authors.initials: JB
authors.lastname: Emans
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology*; D016896:Treatment Outcome; D014945:Wound Healing