Introduction: Antibiotics are commonly administered for surgical drain prophylaxis after spinal fusion, though efficacy against surgical site infection (SSI), type of antibiotic regimen, and length of optimal antibiotic use are not well studied. We analyze whether prophylactic antibiotic administration decreases SSI after spinal fusion surgery.
Methods: We studied 249 consecutive patients undergoing spinal fusion surgery. Factors included those patient-related (age, gender, BMI, comorbidities, history of radiation therapy, smoking status, use of antiplatelet medications, anti-coagulation, or chemotherapy), surgery-related (primary or revision surgery, construct length, fusion region, staged procedure, operation time, fusion graft type, topical vancomycin use, estimated blood loss) and drain-related (number of drains utilized, duration of drain utilization, antibiotic prophylaxis duration). Univariate and multivariate analyses were utilized to assess for factors related to development of SSI.
Results: We studied 249 consecutive patients undergoing spinal fusion surgery. Factors included those patient-related (age, gender, BMI, comorbidities, history of radiation therapy, smoking status, use of antiplatelet medications, anti-coagulation, or chemotherapy), surgery-related (primary or revision surgery, construct length, fusion region, staged procedure, operation time, fusion graft type, topical vancomycin use, estimated blood loss) and drain-related (number of drains utilized, duration of drain utilization, antibiotic prophylaxis duration). Univariate and multivariate analyses were utilized to assess for factors related to development of SSI.
Conclusions: We studied 249 consecutive patients undergoing spinal fusion surgery. Factors included those patient-related (age, gender, BMI, comorbidities, history of radiation therapy, smoking status, use of antiplatelet medications, anti-coagulation, or chemotherapy), surgery-related (primary or revision surgery, construct length, fusion region, staged procedure, operation time, fusion graft type, topical vancomycin use, estimated blood loss) and drain-related (number of drains utilized, duration of drain utilization, antibiotic prophylaxis duration). Univariate and multivariate analyses were utilized to assess for factors related to development of SSI.
Patient Care: Identify that neither the number or duration of surgical drains utilized nor the duration of antibiotic prophylaxis had a significant impact on surgical site infection and thus, their continued use must be weighed against the risks of continued use (e.g., c. difficile infection, increased multi-drug resistant bacteria)
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Identify that neither the number or duration of surgical drains utilized nor the duration of antibiotic prophylaxis had a significant impact on surgical site infection