Yıl: 2018 Cilt: 28 Sayı: 6 Sayfa Aralığı: 904 - 909 Metin Dili: İngilizce DOI: 10.5137/1019-5149.JTN.21341-17.2 İndeks Tarihi: 25-06-2019

Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?

Öz:
AIM: To determine whether the washing of implants and autogenous bone grafts with rifampicin, and the irrigation of the surgicalfield using diluted rifampicin, have any significant effect on the prevention of spinal implant infections.MATERIAL and METHODS: A total of 166 consecutive lumbar stenosis and spondylolisthesis patients undergoing lumbarinstrumentation between 2012 and 2016 were analyzed retrospectively. The patients were divided into two groups. Group I (n=85)included patients whose implants were washed with rifampicin immediately before insertion and whose surgical fields were irrigatedwith diluted rifampicin immediately after insertion. Group II (n=81) included the cases without rifampicin application. Both groupswere matched for age, sex, body mass index, and surgical indication. The infection rates of the groups were compared during thefirst 2 postoperative years.RESULTS: No significant difference was found between the infection rate in Group I and Group II. Only 1 case had surgical siteinfection (SSI) in Group I, a rate of 1.17% (1 of 85 patients), whereas 2 patients had SSI in Group II, a rate of 2.46% (2 of 81 patients).CONCLUSION: Peroperative washing of implants with rifampicin and irrigation of the surgical field using diluted rifampicin have notbeen found to be significantly effective in preventing or reducing spinal implant infections. However, further studies with larger seriesneed to be carried out to verify these results.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Beak KH, Lee YS, Park S: The safety and decision making of instrumented surgery in infectious spondylitis. Korean J Spine 13: 120-123, 2016
  • Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA: American Society of HealthSystem Pharmacists (ASHP); Infectious Diseases Society of America (IDSA); Surgical Infection Society (SIS); Society for Healthcare Epidemiology of America (SHEA). Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt) 14: 73-156, 2013
  • Chang FY, Chang MC, Wang ST, Yu WK, Liu CL, Chen TH: Can povidone-iodine solution be used safely in a spinal surgery? Eur Spine J 15: 1005-1014, 2016
  • Deyo RA, Cherkin DC, Loeser JD, Bigos SJ, Ciol MA: Morbidity and mortality in association with operations on the lumbar spine. The influence of age, diagnosis, and procedure. J Bone Joint Surg Am 4: 536-543, 1992
  • Gelalis ID, Arnaoutoglou CM, Politis AN, Batzaleksis NA, Katonis PG, Xenakis TA: Bacterial wound contamination during simple and complex spinal procedures. A prospective clinical study. Spine J 11: 1042-1048, 2011
  • Imajo Y, Taguchi T, Neo M, Otani K, Ogata T, Ozawa H, Miyakoshi N, Murakami H, Iguchi T: Complications of spinal surgery for elderly patients with lumbar spinal stenosis in a super-aging country: An analysis of 8033 patients. J Orthop Sci 22: 10-15, 2017
  • Isyar M, Gumustas SA, Yilmaz I, Sirin DY, Tosun HB, Mahirogullari M: Are we economically efficient enough to increase the potential of in vitro proliferation of osteoblasts by means of pharmacochemical agents? Open Orthop J 10: 420-430, 2016
  • Isyar M, Yilmaz I, Nusran G, Guler O, Yalcin S, Mahirogullari M: Safety of bioabsorbable implants in vitro. BMC Surg 15: 127, 2015
  • Kim KT, Cho DC, Sung JK, Kim CH, Kang H, Kim DH: Changes in HbA1c levels and body mass index after successful decompression surgery in patients with type 2 diabetes mellitus and lumbar spinal stenosis: Results of a 2-year follow-up study. Spine J 17(2): 203-210, 2017
  • Kulkarni AG, Patel RS, Dutta S: Does minimally invasive spine surgery minimize surgical site infections? Asian Spine J 10: 1000-1006, 2016
  • Liao JC, Chiu PY, Chen WJ, Chen LH, Niu C: Surgical outcomes after instrumented lumbar surgery in patients of eighty years of age and older. BMC Musculoskelet Disord 17: 402, 2016
  • Makris UE, Edwards TC, Lavallee DC, Bauer Z, Comstock BA, Jarvik JG, Patrick DL, Lotfi M, Friedly JL: Patient priority weighting of the Roland Morris disability questionnaire does not change results of the lumbar epidural steroid injections for spinal stenosis trial. Spine (Phila Pa 1976) 42: 42-48, 2017
  • Mayer HM, Heider F: "Slalom": Microsurgical cross-over decompression for multilevel degenerative lumbar stenosis. Biomed Res Int 2016: 9074257, 2016
  • Miyazaki S, Kakutani K, Maeno K, Takada T, Yurube T, Kurosaka M, Nishida K: Surgical debridement with retention of spinal instrumentation and long-term antimicrobial therapy for multidrug-resistant surgical site infections after spinal surgery: A case series. Int Orthop 40: 1171-1177, 2016
  • Mohamed W, Sommer U, Sethi S, Domann E, Thormann U, Schütz I, Lips KS, Chakraborty T, Schnettler R, Alt V: Intracellular proliferation of S. aureus in osteoblasts and effects of rifampicin and gentamicin on S. aureus intracellular proliferation and survival. Eur Cell Mater 28: 258-268, 2014
  • Mori K, Nishizawa K, Nakamura A, Imai S: Short-term clinical result of cortical bone trajectory technique for the treatment of degenerative lumbar spondylolisthesis with more than 1-year follow-up. Asian Spine J 10: 238-244, 2016
  • Oksuz E, Deniz FE, Gunal O, Demir O, Barut S, Markoc F, Erkorkmaz U: Which method is the most effective for preventing postoperative infection in spinal surgery? Eur Spine J 25: 1006-1011, 2016
  • Phillips M, Rosenberg A, Shopsin B, Cuff G, Skeete F, Foti A, Kraemer K, Inglima K, Press R, Bosco J: Preventing surgical site infections: A randomized, open-label trial of nasal mupirocin ointment and nasal povidone-iodine solution. Infect Control Hosp Epidemiol 35: 826-832, 2014
  • Schuster JM, Rechtine G, Norvell DC, Dettori JR: The influence of perioperative risk factors and therapeutic interventions on infection rates after spine surgery: A systematic review. Spine (Phila Pa 1976) 35: 125-137, 2010
  • Tomov M, Mitsunaga L, Durbin-Johnson B, Nallur D, Roberto R: Reducing surgical site infection in spinal surgery with betadine irrigation and intrawound vancomycin powder. Spine (Phila Pa 1976) 40: 491-499, 2015
  • Ulivieri S, Toninelli S, Petrini C, Oliveri G: Prevention of postoperative infection in spine surgery by wound irrigation with a solution of povidone-iodine and hydrogen peroxide. J Neurosurg Sci 55: 89-92, 2011
  • Weber C, Lønne G, Rao V, Jakola AS, Solheim O, Nerland U, Rossvoll I, Nygaard ØP, Peul WC, Gulati S: Surgical management of lumbar spinal stenosis: A survey among Norwegian spine surgeons. Acta Neurochir (Wien) 159: 191- 197, 2017
  • Whiffen JR, Neuwirth MG: Spinal stenosis. In: Bridwell KH, DeWald RL (eds), The Textbook of Spinal Surgery. 2nd ed. Philadelphia: Lippincott Raven Publisher, 1997:1561-1580
  • Yaldiz C, Yaldiz M, Ceylan N, Kacira OK, Ceylan D, Kacira T, Kizilcay G, Tanriverdi T: Retrospective, demographic, and clinical investigation of the causes of postoperative infection in patients with lumbar spinal stenosis who underwent posterior stabilization. Medicine (Baltimore) 94: 1177, 2015
  • Yuan HA, Garfin SR, Dickman CA, Mardjetko SM: A historical cohort study of pedicle screw fixation in thoracic, lumbar, and sacral spinal fusions. Spine 19: 2279-2296, 1994
APA Karaarslan N, YILMAZ I, özbek h, OZNAM K, ATEŞ Ö, ERDEM İ (2018). Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. , 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
Chicago Karaarslan Numan,YILMAZ Ibrahim,özbek hanefi,OZNAM Kadir,ATEŞ Özkan,ERDEM İlknur Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. (2018): 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
MLA Karaarslan Numan,YILMAZ Ibrahim,özbek hanefi,OZNAM Kadir,ATEŞ Özkan,ERDEM İlknur Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. , 2018, ss.904 - 909. 10.5137/1019-5149.JTN.21341-17.2
AMA Karaarslan N,YILMAZ I,özbek h,OZNAM K,ATEŞ Ö,ERDEM İ Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. . 2018; 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
Vancouver Karaarslan N,YILMAZ I,özbek h,OZNAM K,ATEŞ Ö,ERDEM İ Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. . 2018; 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
IEEE Karaarslan N,YILMAZ I,özbek h,OZNAM K,ATEŞ Ö,ERDEM İ "Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?." , ss.904 - 909, 2018. 10.5137/1019-5149.JTN.21341-17.2
ISNAD Karaarslan, Numan vd. "Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?". (2018), 904-909. https://doi.org/10.5137/1019-5149.JTN.21341-17.2
APA Karaarslan N, YILMAZ I, özbek h, OZNAM K, ATEŞ Ö, ERDEM İ (2018). Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. Turkish Neurosurgery, 28(6), 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
Chicago Karaarslan Numan,YILMAZ Ibrahim,özbek hanefi,OZNAM Kadir,ATEŞ Özkan,ERDEM İlknur Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. Turkish Neurosurgery 28, no.6 (2018): 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
MLA Karaarslan Numan,YILMAZ Ibrahim,özbek hanefi,OZNAM Kadir,ATEŞ Özkan,ERDEM İlknur Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. Turkish Neurosurgery, vol.28, no.6, 2018, ss.904 - 909. 10.5137/1019-5149.JTN.21341-17.2
AMA Karaarslan N,YILMAZ I,özbek h,OZNAM K,ATEŞ Ö,ERDEM İ Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. Turkish Neurosurgery. 2018; 28(6): 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
Vancouver Karaarslan N,YILMAZ I,özbek h,OZNAM K,ATEŞ Ö,ERDEM İ Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?. Turkish Neurosurgery. 2018; 28(6): 904 - 909. 10.5137/1019-5149.JTN.21341-17.2
IEEE Karaarslan N,YILMAZ I,özbek h,OZNAM K,ATEŞ Ö,ERDEM İ "Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?." Turkish Neurosurgery, 28, ss.904 - 909, 2018. 10.5137/1019-5149.JTN.21341-17.2
ISNAD Karaarslan, Numan vd. "Is Implant Washing and Wound Irrigation with Rifampicin Effective for Preventing Surgical Site Infections in Lumbar Instrumentation?". Turkish Neurosurgery 28/6 (2018), 904-909. https://doi.org/10.5137/1019-5149.JTN.21341-17.2