Abstract
Background
Surgical Site Infection (SSI) is a potential inherent risk of any surgical intervention. SSI can pose significant consequences especially in spinal surgery. Previous research showed that there are seasonal variations in the incidence of SSI with numbers peaking in summer months.
Objective
To evaluate (1) incidence of Surgical Site Infection (SSI) for consecutive operations in a tertiary center, (2) the commonest pathogen, (3) The management in our unit and its long-term outcome, and (4) Effect of seasonal change on SSI.
Methods
Consecutive spinal operations (N = 4557) between Jan 2007 – Jan 2012 were studied looking for SSI using the Centres for Disease Control National Health Safety Network criteria. All patients with SSI positive criteria were included in the study. Further evaluation was based on the study objectives.
Results
4557 procedures were assessed, of which 30.5% were Decompressions, Variable Thoraco-Lumbar Fusions (inc. ALIf, TLIF, XLIF, Deg. Scoliois correction) 25.8%, Cervical operations 18.8%, Scoliosis operations 10.5%, Decompressions and Interspinious spacers 6.9%, and miscellaneous procedures were 7.5%. In total 8.5% of cases were revision surgeries. The incidence of SSI was 4.9% with 62.1% Male and 37.9% Females. Commonest organisms were Coagulase Negative Staph 31.7%, Staph Aureus 26.8%, Pseudomonas 7%, MRSA 4%, and polymicrobial 30.5%. The average time to detection of infection was 23 days (3–200). Of the positive SSI cases, 9.75% needed surgical debridement. 2.4% needed removal of metal work/Replacement. They all made uneventful long-term recovery. 54.9% of SSI had their operations in the summer months, while 45.1% were operated in the Autumn/Winter months.
Conclusion
Bearing in mind the low infection rate of deep surgical site infections we encountered: Most of the SSI cases were effectively treated in our unit by using antibiotics only; The close liaison with our microbiology unit was and remains of paramount importance; There is no clear difference found in our study between Summer/Spring and Autumn/Winter months in the rate of developing SSI.