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spine surgical site infection

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https://www.readbyqxmd.com/read/28505031/povidone-iodine-solutions-inhibit-cell-migration-and-survival-of-osteoblasts-fibroblasts-and-myoblasts
#1
James X Liu, Jordan A Werner, John A Buza, Thorsten Kirsch, Joseph D Zuckerman, Mandeep S Virk
STUDY DESIGN: In vitro laboratory study. OBJECTIVE: The purpose of this study was to identify the effect of dilute povidone-iodine (PVI) solutions on human osteoblast, fibroblast and myoblast cells in vitro. SUMMARY OF BACKGROUND DATA: Dilute PVI wound lavage has been used successfully in spine and joint arthroplasty procedures to prevent post-operative surgical site infection, but their biologic effect on host cells is largely unknown. METHODS: Human primary osteoblasts, fibroblasts, and myoblasts were expanded in cell culture and subjected to various concentrations of PVI (0%, 0...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28498056/risk-factors-for-surgical-site-infections-and-assessment-of-vancomycin-powder-as-a-preventive-measure-in-patients-undergoing-first-time-cranioplasty
#2
Kingsley O Abode-Iyamah, Hsiu-Yin Chiang, Nolan Winslow, Brian Park, Mario Zanaty, Brian J Dlouhy, Oliver E Flouty, Zachary D Rasmussen, Loreen A Herwaldt, Jeremy D Greenlee
OBJECTIVE Craniectomy is often performed to decrease intracranial pressure following trauma and vascular injuries. The subsequent cranioplasty procedures may be complicated by surgical site infections (SSIs) due to prior trauma, foreign implants, and multiple surgeries through a common incision. Several studies have found that intrawound vancomycin powder (VP) is associated with decreased risk of SSIs after spine operations. However, no previously published study has evaluated the effectiveness of VP in cranioplasty procedures...
May 12, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28484678/reduced-surgical-site-infection-rates-following-spine-surgery-using-an-enhanced-prophylaxis-protocol
#3
Alexa M Dessy, Frank J Yuk, Akbar Y Maniya, James G Connolly, John T Nathanson, Jonathan J Rasouli, Tanvir F Choudhri
BACKGROUND: Postoperative surgical site infection (SSI) is a common complication after spine surgery. Reduction of SSI has many benefits including, but not limited to, the reduced length of stay, readmission rates, and morbidity and mortality. OBJECTIVE: To determine whether an enhanced antibiotic prophylaxis reduced the rate of surgical site infections in spine surgery. METHODS: This is a retrospective observation study which analyzed the incidence of postoperative SSI following a consecutive series of 1,486 cervical, thoracic and lumbar spine operations performed at a single institution by the senior author between the dates of October 2001 to March 2014...
April 6, 2017: Curēus
https://www.readbyqxmd.com/read/28479791/minimally-invasive-versus-open-spine-surgery-what-does-the-best-evidence-tell-us
#4
Shearwood McClelland, Jeffrey A Goldstein
BACKGROUND: Spine surgery has been transformed significantly by the growth of minimally invasive surgery (MIS) procedures. Easily marketable to patients as less invasive with smaller incisions, MIS is often perceived as superior to traditional open spine surgery. The highest quality evidence comparing MIS with open spine surgery was examined. METHODS: A systematic review of randomized controlled trials (RCTs) involving MIS versus open spine surgery was performed using the Entrez gateway of the PubMed database for articles published in English up to December 28, 2015...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28463620/robotic-versus-fluoroscopy-guided-pedicle-screw-insertion-for-metastatic-spinal-disease-a-matched-cohort-comparison
#5
Volodymyr Solomiichuk, Julius Fleischhammer, Granit Molliqaj, Jwad Warda, Awad Alaid, Kajetan von Eckardstein, Karl Schaller, Enrico Tessitore, Veit Rohde, Bawarjan Schatlo
OBJECTIVE Robot-guided pedicle screw placement is an established technique for the placement of pedicle screws. However, most studies have focused on degenerative disease. In this paper, the authors focus on metastatic spinal disease, which is associated with osteolysis. The associated lack of dense bone may potentially affect the automatic recognition accuracy of radiography-based surgical assistance systems. The aim of the present study is to compare the accuracy of the SpineAssist robot system with conventional fluoroscopy-guided pedicle screw placement for thoracolumbar metastatic spinal disease...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28458067/effect-of-liberal-blood-transfusion-on-clinical-outcomes-and-cost-in-spine-surgery-patients
#6
Taylor E Purvis, C Rory Goodwin, Rafael De la Garza-Ramos, A Karim Ahmed, Virginie Lafage, Brian J Neuman, Peter G Passias, Khaled M Kebaish, Steven M Frank, Daniel M Sciubba
BACKGROUND CONTEXT: Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin (Hb) trigger-defined as an intraoperative Hb level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8 and 10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. PURPOSE: This study aimed to describe the perioperative outcomes and economic cost associated with liberal Hb trigger transfusion among spine surgery patients...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28451485/anterior-cervical-infection-presentation-and-incidence-of-an-uncommon-postoperative-complication
#7
George M Ghobrial, James S Harrop, Rick C Sasso, Chadi A Tannoury, Tony Tannoury, Zachary A Smith, Wellington K Hsu, Paul M Arnold, Michael G Fehlings, Thomas E Mroz, Anthony F De Giacomo, Bruce C Jobse, Ra'Kerry K Rahman, Sara E Thompson, K Daniel Riew
STUDY DESIGN: Retrospective multi-institutional case series. OBJECTIVE: The anterior cervical discectomy and fusion (ACDF) affords the surgeon the flexibility to treat a variety of cervical pathologies, with the majority being for degenerative and traumatic indications. Limited data in the literature describe the presentation and true incidence of postoperative surgical site infections. METHODS: A retrospective multicenter case series study was conducted involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network, selected for their excellence in spine care and clinical research infrastructure and experience...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28441310/a-dose-response-curve-for-a-gram-negative-spinal-implant-infection-model-in-rabbits
#8
Joseph L Laratta, Jamal N Shillingford, Nathan Hardy, Ronald A Lehman, Lawrence G Lenke, K Daniel Riew
STUDY DESIGN: Randomized complete block animal spinal implant infection model with internal control. OBJECTIVE: To develop a spinal implant animal infection model to simulate postoperative gram-negative wound infection. SUMMARY OF BACKGROUND DATA: Implant-associated surgical site infections (SSI) remain a dreaded complication of spinal surgery. Currently, over 30% of all spine SSIs are secondary to gram-negative bacteria. Traditional animal models have utilized gram-positive inoculums to simulate postoperative infection, but there exists no model in the literature for gram-negative infection in the setting of spinal instrumentation...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28422796/waterless-hand-rub-versus-traditional-hand-scrub-methods-for-preventing-the-surgical-site-infection-in-orthopaedic-surgery
#9
Kentaro Iwakiri, Akio Kobayashi, Masahiko Seki, Yoshiyuki Ando, Tadao Tsujio, Masatoshi Hoshino, Hiroaki Nakamura
STUDY DESIGN: A retrospective cohort study with prospectively collected data OBJECTIVE.: The aim of this study was to compare SSI incidences, the cost of hand hygiene agents, and hand hygiene time between the traditional hand scrub and the waterless hand rub protocols before orthopaedic surgery. SUMMARY OF BACKGROUND DATA: Surgical-site-infections (SSI) prolong hospitalization and are a leading nosocomial cause of morbidity as well as a source of excess cost. Recently, a waterless hand rub protocol comprising alcohol based chlorhexidine gluconate for use before surgery was developed, but no studies have yet examined its utility in orthopaedic surgery...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28399544/intrawound-tobramycin-powder-eradicates-surgical-wound-contamination-an-in-vivo-rabbit-study
#10
Joseph L Laratta, Jamal N Shillingford, Nathan Hardy, Joseph M Lombardi, Comron Saifi, Alexander Romanov, Lawrence G Lenke, Ronald A Lehman, K Daniel Riew
STUDY DESIGN: Therapeutic anti-infective trial in rabbitsOBJECTIVE.: The purpose of the present study was to assess the efficacy of intrawound tobramycin powder in terms of eradicating a known bacterial contamination in an Escherichia coli infected rabbit spinal implantation model. SUMMARY OF BACKGROUND DATA: Implant-associated surgical site infections (SSI) remain a dreaded complication of spinal surgery. Currently, over 30% of all spine SSIs are secondary to gram-negative bacteria...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28394747/risk-and-protective-factors-associated-with-surgical-infections-among-spine-patients
#11
REVIEW
Alyssa G Blood, Melanie F Sandoval, Evalina Burger, Katherine Halverson-Carpenter
BACKGROUND: The purpose of the study was to identify patient-specific and procedure-specific risk and protective factors associated with post-operative surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL, PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the past 10 years (January 2003-March 2015). The keywords and combinations used in the search included: Spine surgery, post-operative infection, risk factors, orthopedic infections...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28387851/does-intrawound-vancomycin-application-during-spine-surgery-create-vancomycin-resistant-organism
#12
Silky Chotai, Patty W Wright, Andrew T Hale, Whitney A Jones, Matthew J McGirt, Joshua C Patt, Clinton J Devin
BACKGROUND: Surgical site infection (SSI) following spine surgery is a morbid and expensive complication. The use of intrawound vancomycin is emerging as a solution to reduce SSI. The development of vancomycin-resistant pathogens is an understandable concern. OBJECTIVE: To determine the occurrence of vancomycin-resistant SSI in patients with and without use of intrawound vancomycin. METHODS: Patients undergoing elective spine surgery were dichotomized based on whether intrawound vancomycin was applied...
April 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377245/postoperative-non-pathological-fever-after-spinal-surgery-incidence-and-risk-factor-analysis
#13
Junghan Seo, Jin Hoon Park, Eun Hee Song, Young-Seok Lee, Sang Ku Jung, Sang Ryong Jeon, Seung Chul Rhim, Sung Woo Roh
BACKGROUND: Although there are many postoperative febrile causes, surgical site infection has always been considered as one of the major causes, but it should be excluded; we encountered many patients who showed delayed postoperative fever that was not related to wound infection after spinal surgery. We aimed to determine the incidence of delayed postoperative fever and its characteristics after spinal surgery, and to analyze the causal factors. METHODS: A total of 250 patients who underwent any type of spinal surgery were analyzed...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#14
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350942/prevention-of-surgical-site-infection-in-spine-surgery
#15
Paul A Anderson, Jason W Savage, Alexander R Vaccaro, Kristen Radcliff, Paul M Arnold, Brandon D Lawrence, Mohammed F Shamji
BACKGROUND: Spine surgery is complicated by an incidence of 1% to 9% of surgical site infection (SSI). The most common organisms are gram-positive bacteria and are endogenous, that is are brought to the hospital by the patient. Efforts to improve safety have been focused on reducing SSI using a bundle approach. The bundle approach applies many quality improvement efforts and has been shown to reduce SSI in other surgical procedures. OBJECTIVE: To provide a narrative review of practical solutions to reduce SSI in spine surgery...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28336247/surgical-case-order-has-an-effect-on-the-risk-of-subsequent-periprosthetic-joint-infection
#16
Antonia F Chen, Michael M Kheir, Joshua M Greenbaum, Camilo Restrepo, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a serious complication with multiple etiologies. Prior spine literature has shown that later cases in the day were more likely to develop surgical site infection. However, the effect of case order on PJI after TJA is unknown. This study aims to determine the influence of case order, prior infected case, and terminal cleaning on the risk for a subsequent PJI. METHODS: A retrospective, single-institution study was conducted on 31,499 TJAs performed from 2000 to 2014...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28335413/chitin-oligosaccharide-cos-reduces-antibiotics-dose-and-prevents-antibiotics-caused-side-effects-in-adolescent-idiopathic-scoliosis-ais-patients-with-spinal-fusion-surgery
#17
Yang Qu, Jinyu Xu, Haohan Zhou, Rongpeng Dong, Mingyang Kang, Jianwu Zhao
Antibiotics are always considered for surgical site infection (SSI) in adolescent idiopathic scoliosis (AIS) surgery. However, the use of antibiotics often causes the antibiotic resistance of pathogens and side effects. Thus, it is necessary to explore natural products as drug candidates. Chitin Oligosaccharide (COS) has anti-inflammation and anti-bacteria functions. The effects of COS on surgical infection in AIS surgery were investigated. A total of 312 AIS patients were evenly and randomly assigned into control group (CG, each patient took one-gram alternative Azithromycin/Erythromycin/Cloxacillin/Aztreonam/Ceftazidime or combined daily), experiment group (EG, each patient took 20 mg COS and half-dose antibiotics daily), and placebo group (PG, each patient took 20 mg placebo and half-dose antibiotics daily)...
March 14, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28331279/unplanned-90-day-readmissions-in-a-specialty-orthopaedic-unit-a-prospective-analysis-of-consecutive-12729-admissions
#18
Mahender Avinash, S Rajasekaran, Siddharth N Aiyer
INTRODUCTION: Unplanned readmissions are an undesirable and expensive outcome of clinical practice. Previous reported literature is limited by retrospective study designs and 30 day study intervals. We analyzed causes for 90-day unplanned readmission, temporal occurrence of major causes, possible predisposing factors, bed days lost and economic impact. MATERIALS & METHODS: A prospective analysis of 12729 admissions was performed over 1 year in an Orthopaedic unit...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#19
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28321572/the-extent-of-environmental-and-body-contamination-through-aerosols-by-hydro-surgical-debridement-in-the-lumbar-spine
#20
David Putzer, Ricarda Lechner, Debora Coraca-Huber, Astrid Mayr, Michael Nogler, Martin Thaler
INTRODUCTION: Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface. MATERIALS AND METHODS: On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
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