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  • An Experimental Study: Which Method is the Most Effective for Preventing Postoperative Infection in Spinal Procedures?

    Final Number:

    Erol Oksuz MD; Fatih Ersay Deniz; Ozgur Gunal; Ozgur Demir; Huseyin Sener Barut; Fatma Markoc; Unal Erkorkmaz

    Study Design:
    Laboratory Investigation

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Several methods have been used to reduce the infection rate in spinal surgeries with instrumentation. In the present study, the efficiency of antibiotic prophylaxis, silver-plated screws, and local rifamycin application to the surgical site were investigated in an experimental animal model. Staphylococcus aureus was used as the pathogen.

    Methods: This study was performed with the approval of the Experimental Animals Ethics Committee at the local Experimental and Clinical Research Center. In the present study, 50 six-month-old female Wistar albino rats were used. The animals were randomly numbered and divided into five groups of 10 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 pre-operative 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 sacrificed 15 days later. The samples were evaluated for microbiological and histological findings.

    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.

    Patient Care: by reducing post-operative infections

    Learning Objectives: By the conclusion of this session, participants should be able to identify more effective prophylaxy against post-operative infections

    References: 1. Fang A, Hu SS, Endres N, Bradford DS. Risk Factors for Infection After Spinal Surgery. Spine. 2005; 30: 1460-1465. 2. Lim, MR, Lee JY, Vaccaro AR. Surgical Infections in the Traumatized Spine. Clinical Orthopaedics And Related Research. 2006; 444: 114-119. 3. Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR. Postoperative posterior spinal wound infections. Clin Orthop Relat Res. 1992; 284: 99-108. 4. Weinstein MA, McCabe JP, Cammisa FP Jr. Postoperative spinal wound infection: a review of 2,391 consecutive index procedures. J Spinal Disord. 2000;13(5):422-426. 5. Hodges SD, Humphreys SC, Egk JC, Covington LA, Kurzynske NG. Low Postoperative Infection Rates With Instrumented Lumbar Fusion. Southern Medical Journal. 1998; 91: 1132-1136. 6. Silber JS, Anderson DG, Vaccaro AR, Anderson PA, McCormick P. Management of postprocedural discitis. Spine J. 2002; 2(4):279-287. 7. Barker FG. Efficacy Of Prophylactic Antibiotic Therapy In Spinal Surgery: A Meta-Analysis. Neurosurgery. 2002; 51: 391-401. 8. Hellbusch LC, Helzer-Julin M, Doran SE, et al. Single-dose vs multiple-dose antibiotic prophylaxis in instrumented lumbar fusion--a prospective study. Surg Neurol. 2008; 70(6): 622-7; discussion 627. 9. Van Middendorp JJ, Pull ter Gunne AF, Schuetz M, et al. A Methodological Systematic Review on Surgical Site Infections Following Spinal Surgery. Spine. 2012; 37(24): 2034–2045. 10. Ofluoglu EA, Zileli M, Aydin D, Baris YS, et al. Implant-related infection model in rat spine. Arch Orthop Trauma Surg. 2007; 127:391–396. 11. Watters WC, Baisden J, Bono CM, et al. Antibiotic prophylaxis in spine surgery: an evidence-based clinical guideline for the use of prophylactic antibiotics in spine surgery. The Spine Journal. 2009; 9: 142–146. 12. Walters R, Rahmat R, Shimamura Y, Fraser R, Moore R. Prophylactic Cephazolin to Prevent Discitis in an Ovine Model. Spine. 2006; 31(4): 391–396. 13. Senneville E, Joulie D, Legout L, et al. Outcome and Predictors of Treatment Failure in Total Hip/Knee Prosthetic Joint Infections Due to Staphylococcus aureus. Clin Inf Disease. 2011; 53: 334-340. 14. Muttaiyah S, Ritchie S, John S, Mee E, Roberts S. Efficacy of antibiotic-impregnated external ventricular drain catheters. Journal of Clinical Neuroscience. 2010; 17: 296–298. 15. Secinti KD, Ayten M, Kahilogullari G, Kaygusuz G, Ugur HC, Attar A. Antibacterial effects of electrically activated vertebral implants. Journal of Clinical Neuroscience. 2008; 15: 434–439.

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