SURGICAL SITE INFECTION IN POSTERIOR SPINE SURGERY Owolabi BS, Omotayo A. Ojo, Oseni A Lagos University Teaching Hospital, Lagos, Nigeria Keywords: Surgical Site Infection, Posterior Spine Surgery, Spine Rehabilitation Centre, Spine Instrumentation, Diabetes and Spine Surgery

QUICK OVERVIEW Background on surgical site infection in posterior spine surgery What it is Why it happens Implications of its presence Specific Objectives of the research Outcome of the research

OUTLINE Problem Statement Related Works Methods Results Summary

PROBLEM STATEMENT Hospital acquired infection is one of the major infectious diseases having a huge economic impact worldwide WHO Surgical site infection (SSI) is the second most common health care-associated infection (HCAI). SSIs remain a substantial cause of morbidity, prolonged hospitalization, and death, despite the advances been made in infection control practices.

METHODS A retrospective cross-sectional study of all consecutive patients who had posterior spine surgeries between January 2012 and July 2014. Patients who had spinal surgery for an infective process were excluded. All patients who had wound infection were noted and culture sensitivity was noted. Results were analysed to get the infection rate, reasons for prolonged stay on admission as well as possible contributing factors to wound infections.

RESULTS A total of 62 patients records was reviewed (M:F ratio 1.2:1) SSI was classified as deep or superficial to the fascia 10 (16.1%) patients were found to have an SSI 7 (11.3%) patients having deep infections. 3 (4.8%) had superficial infection. Vertebral level operated, aetiology and diagnosis were not statistically significant for SSI. However, an increase in the rate of SSI was observed with instrumentation. Comorbidities such as poorly controlled diabetes mellitus, Obesity, Religion (JW) were noted to be associated with increased rate of infections

RESULTS Diabetes mellitus was found to be an independent risk factor for all SSI and deep SSI (P = 0.003 and P = 0.042). The length of surgery time was also found to be a risk factor for SSI (P = 0.038). Patients who had their wound exposed inadvertently before day 10 postop also had increased rate of SSI. Demands for in-patient rehabilitation are responsible for prolonged hospital admission. The organisms cultured were Pseudomonas and staph spp.

RESULTS

Incidence of SSI in diabetes RESULTS Incidence of SSI in diabetes Univariate comparison of diabetes mellitus in patients with superficial or deep SSI after spinal surgery

RESULTS

SUMMARY The incidence of SSI in posterior spine surgery In this study is 16.1% Diabetes mellitus is a risk factor for all SSIs and deep SSI The length of surgery time is a risk factor for SSI There is an increase in the rate of SSI with instrumentation. Patients who had their wound exposed inadvertently before day 10 postop have increased rate for SSI. Obesity and Religion (JW) are also risk factors for SSI

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