title: [Management of postoperative wound infections following spine surgery : First results of a multicenter study].
abstract: BACKGROUND
  The number of spinal surgeries has increased significantly in the last decade, which has led to a correlating increase in the number of problems related to wound healing infection. Current literature has reported a spinal wound infection rate of 0.4 to 20 %. The gold standard for surgical restoration of the infection is to use supportive antibiotics, but this concept of wound management in infections is often not sufficiently standardized and shows a large variance between individual clinics. The present study is to first collect data on the number of wound infections, the clinic's internal standards, the use of methods and tools and the management of revisions in Germany.
  
  
  METHODS
  A questionnaire has been designed for detecting the number of postoperative wound infections, which need to be treated surgically, and the various treatment regimens used. The questionnaire was sent to all members of the DWG (n = 1275). An example of the questionnaire was to determine clinical internal standards and the procedure for the initial treatment of wound infection, the procedure for second look surgery and the number of revisions requested to infection healing.
  
  
  RESULTS
  The study has accepted 67 answer sheets covering a period from June 2013-November 2013. On average, the participating hospitals perform 582 spinal operations and an average of 8 revision surgeries due to infection annually. The average rate of infection was 1.7 %. 55 % reported having no fixed standard of care. 97 % reported wound irrigation and debridement during the first revision. Indication for second look revisions was based on the local examination of the wound conditions. On average 2.2 revisions had been performed to reach effective wound healing. 81 % of the colleagues showed readiness to participate in a multicenter trial.
  
  
  CONCLUSIONS
  The results show that there is a need for uniform standards in the treatment of postoperative infections. Surgical debridement and lavage have a major role in the treatment of infection. The overall rate of postoperative infections, of the clinics surveyed, was approximately 1.7 % per year. The infections were healed with approximately 2 revisions utilizing variety of different treatment strategies.
authors: Abteilung für Wirbelsäulenorthopädie, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland. marcus.rickert@friedrichsheim.de.
authors: M
authors: M
authors: Rickert
authors: Zentrum für Wirbelsäulenchirurgie, BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Deutschland.
authors: P
authors: P
authors: Schleicher
authors: Abteilung für Wirbelsäulenorthopädie, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland.
authors: C
authors: C
authors: Fleege
authors: Abteilung für Wirbelsäulenorthopädie, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland.
authors: M
authors: M
authors: Arabmotlagh
authors: Abteilung für Wirbelsäulenorthopädie, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland.
authors: M
authors: M
authors: Rauschmann
authors: Klinik für Wirbelsäulentherapie, Wirbelsäulenzentrum, Orthopädische Fachkliniken der Hessing Stiftung, Augsburg, Deutschland.
authors: F
authors: F
authors: Geiger
authors: Zentrum für Wirbelsäulentherapie, Schön Klinik Nürnberg Fürth, Fürth, Deutschland.
authors: K J
authors: KJ
authors: Schnake
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003646:Debridement / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007796:Laminectomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012307:Risk Factors; D013123:Spinal Fusion / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complication, postoperative; Debridement; Spinal column; Treatment; infection, postoperative