Postoperative deep wound infection in adults after posterior lumbosacral spine fusion with instrumentation: Incidence and management
Postoperative deep wound infection in adults after posterior lumbosacral spine fusion with instrumentation: Incidence and management
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DOI：
10.1097/00002517-200002000-00009
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发表时间：
2000-02-01
期刊：
影响因子：
--
通讯作者：
Perra, JH
中科院分区：
文献类型：
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作者：
Picada, R;Winter, RB;Perra, JH
作者回顾了 817 例成人腰骶椎融合术，发现深部伤口感染的发生率为 3.2%。这项研究的主要焦点是这些感染的管理，特别关注是否需要移除植入物。一位传染病专家表示，如果不移除金属植入物，腰部融合伤口的急性感染就无法治愈。这种观点与作者的日常经验形成鲜明对比，并促使了这项研究。作者确定并回顾了 817 例成人器械式后腰骶关节融合术病例。对任何深部伤口感染病例进行详细分析，感染率为 3.2%（26 例）。其中，24 例通过积极清创和二次闭合方案实现了干净、闭合的伤口，无需移除器械。通过早期诊断、在手术室全身麻醉下大力清创、延迟一期或二期闭合以及适当的抗生素覆盖等积极方法，无需移除器械即可获得干净、闭合的伤口。
The authors reviewed 817 instrumented lumbosacral fusions in adults and found an incidence of 3.2% deep wound infections. The primary focus of this study was the management of these infections, with particular attention to whether the implants needed to be removed. A consulting infectious disease specialist indicated that an acute infection of a low back fusion wound could not be healed without removal of the metallic implants. This opinion was in contrast to the authors' daily experience and prompted this study. The authors identified and reviewed 817 cases of instrumented posterior lumbosacral arthrodeses in adults. A detailed analysis of any case with a deep wound infection was performed and yielded and infection rate of 3.2% (26 patients). Of these, 24 achieved a clean, closed wound without removal of instrumentation through a protocol of aggressive debridement and secondary closure. Instrumentation removal is not necessary to obtain a clean, closed wound using an aggressive approach with early diagnosis, vigorous debridement in the operative room under general anesthesia, delayed primary or secondary closure, and appropriate antibiotic coverage.