Case Series of the Management of Surgical Site Infection Following Thoracic Spinal Surgeries During COVID Pandemic
Volume 3 | Issue 1 | April-September 2022 | page: 24-31 | Neetin Mahajan, Sunny Sangma, Jayesh Mhatre, Pritam Talukder
DOI: https://doi.org/10.13107/bbj.2022.v03i01.036
Authors: Neetin Mahajan [1], Sunny Sangma [1], Jayesh Mhatre [1], Pritam Talukder [1]
[1] Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Sunny Sangma,
Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
E-mail: Sunnysangma11@gmail.com
Abstract
Introduction: Post-operative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and post-operative care, wound infection continues to compromise patient outcome after spinal surgery. This kind of infection places the patient at risk for pseudoarthrosis, adverse neurologic sequelae, chronic pain, deformity, and even death. In spite of all preventive measures, the SSI following spinal surgeries are 1% among operated spinal instrumentation.
Case Series: Here, we present a series of three patients who presented to us with post-operative surgical site infection (SSI) in spine surgery in the form of wound, discharge, and other complaints. Out of all, two of them were operated with debridement and skin closure followed by broad spectrum IV antibiotics and one of them managed with vacuum-assisted closure dressing and high antibiotics sensitive to organisms found in wound culture. Optimization by building up hemoglobin, supplementing micronutrients including Vitamin C, D, and B12 and high protein diet was started as adjuvant therapy and all of them was discharged with healthy wound.
Conclusion: SSI in spine surgery is a common but challenging complication, particularly after instrumental spinal arthrodesis. Using meticulous aseptic technique, intra-operative irrigation, prophylactic antibiotics, and optimizing patient factors preoperatively are key to preventing a SSI. In patients who still develop an infection despite efforts at prevention, timely diagnosis and treatment are critical. Instrumentation can be retained while still successfully clearing an early infection, although following fusion, instrumentation can be removed if lifetime oral antibiotic suppression is either not indicated or undesirable.
Keywords: Spine surgery, Postoperative infections, Surgical site infection, Spinal instrumentation.
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| How to Cite this Article: Mahajan N, Sangma S, Mhatre J, Talukder P | Case Series of the Management of Surgical Site Infection Following Thoracic Spinal Surgeries During COVID Pandemic | Back Bone: The Spine Journal | April-September 2022; 3(1): 24-31. https://doi.org/10.13107/bbj.2022.v03i01.036 |
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