Authors (including presenting author) :
Lau ST(1), Cheung PWH(2), Cheung JPY(2)
Affiliation :
(1) Central Nursing Division , The Duchess of Kent Children’s Hospital at Sandy Bay, (2) Department of Orthopaedics and Traumatology, The University of Hong Kong
Introduction :
Wound infection is a dreaded complication of spine surgery. Patients have prolonged hospital stay, worse treatment outcomes and may require further surgery. This also leads to an increase in workload for front-line staff, burden on the healthcare infrastructure with increased bed occupancy, and risk of antibiotic resistance. The types of infection, relevant patient characteristics and risk factors have not been elucidated in the past for our region. We aim to study the prevalence and characteristics of spine infections at the Hong Kong West Cluster (HKWC) hospitals.
Objectives :
(1)To determine the 2-year infection rate of high-risk spine surgeries; (2)to determine the relationship between surgery type, comorbidities and the rate of postoperative infection.
Methodology :
This review focused on comorbidities and infection conditions of spine patients operated in HKWC (QMH and DKCH) during the period of January 2017 to December 2018. Inclusion criteria were all adult patients (>18 years) undergoing posterior spinal surgery, and pediatric patients with neuromuscular or syndromal scoliosis. This group was studied as these were the perceived higher risk group for postoperative infections. Exclusion criteria included anterior surgeries, primary infections and other scoliosis in patients <18 years. Information regarding patient particulars, type of surgery, comorbidities, and any adverse wound outcomes (delayed wound healing, postoperative infections treated with antibiotics and/or debridement) was collected.
Result & Outcome :
A total of 460 patients (51.5% male) with mean age of 59.8±18.3 (Range from 7.0 to 97.0) were studied. Of this cohort, most patients were operated for lumbar spinal stenosis (33.5%) followed by cervical disorders (17.8%) and tumour surgery (10.9%). Up to 13.7% had delayed wound healing, 11.7% with postoperative infection treated by antibiotics alone, and 4.8% required wound debridement. Postoperative infection requiring debridement was most common for deformity surgeries (25%) followed by tumour surgery (12%). No differences were observed between the three outcome groups with regards to age or history of diabetes mellitus (27-31%). Patients with wound debridement (9%) were more likely to be immunocompromised as compared to delayed wound healing (4%) and postoperative infection treated with antibiotics alone (5%). Postoperative spinal wound infection is not uncommon even in a tertiary spine centre. The highest risk of infection are deformity and tumour surgery. Our operative database will be further mined to determine other risks for infection and the trend in overall rates of infection compared to a decade ago.
Co-location with:
