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
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