Prevention of implant-associated spinal infections: the GAID-protocol

被引:0
|
作者
Przybyl, Joanna Maria [1 ]
Hegewald, Aldemar Andres [1 ]
机构
[1] VAMED Balt Sea Hosp, Dept Neurosurg & Spine Surg, Damp, Germany
来源
FRONTIERS IN SURGERY | 2023年 / 10卷
关键词
surgical site infection; spinal infections; implant-associated infection; sodium hypochlorite/hypochlorous acid; spinal fusion; spondylodiscitis; vertebral osteomyelitis; SURGICAL SITE INFECTION; PRESSURE WOUND THERAPY; TIME-DEPENDENT CONTAMINATION; BACTERIAL-CONTAMINATION; PROPIONIBACTERIUM-ACNES; SURGERY; FUSION; RISK; REDUCE; GLOVES;
D O I
10.3389/fsurg.2023.1308213
中图分类号
R61 [外科手术学];
学科分类号
摘要
ObjectiveThe purpose of this study is to investigate the efficacy of the GAID-Protocol, a bundle of intra- and postoperative infection prevention measures, to reduce implant-associated infections in patients undergoing posterior spinal fusion with instrumentation. These preventive measures are organized into a protocol that includes recommendations for four critical areas of implant protection (acronym GAID): Gloves, Antiseptics: sodium hypochlorite/hypochlorous acid (NaOCl/HOCl), Implants and Drainage-use in large wounds.MethodsWe performed a single-site retrospective review of cases undergoing posterior spinal fusion with instrumentation for primarily degenerative spinal diseases before and after implementation of the GAID-Protocol that was specifically designed to protect against implant-associated infections. The primary outcome was postoperative wound complications requiring surgical intervention, with a particular focus on infectious spondylitis/discitis.Results230 cases were included: 92 (Group A) before and 138 (Group B) after protocol implementation. Overall, wound complications requiring surgical intervention occurred in 7.6% patients in Group A and in 3.6% patients in Group B (p = 0.2297). Of these, infectious spondylitis/discitis was present in 5.4% in Group A and in none of Group B (p = 0.0096). The ratio of infectious spondylitis/discitis to other wound problems was 71% to 29% in Group A, while it was 0% to 100% in Group B (p = 0.0278). The mean time interval between the first revision surgery for wound complications and hospital discharge was significantly different, 38 days SD 20.3 in Group A and 14.4 days SD 8.6 in Group B (p = 0.0442).ConclusionsIn our study, adherence to the GAID-Protocol resulted in a shift from severe to significantly less severe and easier to treat wound complications. Adoption of the GAID-Protocol might contribute to the reduction of implant-associated infections.
引用
收藏
页数:10
相关论文
共 50 条
  • [1] Editorial: Surgical treatment of spinal infections: management of spondylodiscitis and implant-associated vertebral osteomyelitis
    Lang, Siegmund
    Neuhoff, Jonathan
    Hohenberger, Christoph
    Haeckel, Sonja
    FRONTIERS IN SURGERY, 2024, 11
  • [2] Spinal implant-associated infections: a prospective multicentre cohort study
    Margaryan, Donara
    Renz, Nora
    Bervar, Maja
    Zahn, Robert
    Onken, Julia
    Putzier, Michael
    Vajkoczy, Peter
    Trampuz, Andrej
    INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2020, 56 (04)
  • [3] Management and outcome of spinal implant-associated surgical site infections in patients with posterior instrumentation: analysis of 176 cases
    Hickmann, Anne-Katrin
    Bratelj, Denis
    Pirvu, Tatiana
    Loibl, Markus
    Mannion, Anne F.
    O'Riordan, Dave
    Fekete, Tamas
    Jeszenszky, Deszo
    Eberhard, Nadia
    Vogt, Marku
    Achermann, Yvonne
    Haschtmann, Daniel
    EUROPEAN SPINE JOURNAL, 2022, 31 (02) : 489 - 499
  • [4] Lactoferrin Functionalized Biomaterials: Tools for Prevention of Implant-Associated Infections
    Pall, Emoke
    Roman, Alexandra
    ANTIBIOTICS-BASEL, 2020, 9 (08): : 1 - 14
  • [5] Synthesis and evaluation of a novel vancomycin-infused, biomimetic bone graft using a rat model of spinal implant-associated infection
    Rajkovic, Christian J.
    Tracz, Jovanna A.
    Demordaunt, Trevor
    Davidar, A. Daniel
    Perdomo-Pantoja, Alexander
    Judy, Brendan F.
    Zhang, Kevin Yang
    Hernandez, Vaughn N.
    Lin, Jessica
    Lazzari, Julianna L.
    Cottrill, Ethan
    Witham, Timothy F.
    NORTH AMERICAN SPINE SOCIETY JOURNAL, 2024, 18
  • [6] Implant-Associated Spinal Infections in Children How Can We Improve Diagnosis and Management?
    Lake, Jason
    Gordon, Oren
    INFECTIOUS DISEASE CLINICS OF NORTH AMERICA, 2022, 36 (01) : 101 - 123
  • [7] Clinical Characteristics and Outcomes of Staphylococcus aureus Implant-associated Infections in Children
    Foster, Catherine E.
    Lamberth, Linda B.
    Kaplan, Sheldon L.
    Hulten, Kristina G.
    PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2019, 38 (08) : 808 - 811
  • [8] Preventing Implant-Associated Infections by Silver Coating
    Kuehl, Richard
    Brunetto, Priscilla S.
    Woischnig, Anne-Kathrin
    Varisco, Massimo
    Rajacic, Zarko
    Vosbeck, Juerg
    Terracciano, Luigi
    Fromm, Katharina M.
    Khanna, Nina
    ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2016, 60 (04) : 2467 - 2475
  • [9] Management of Expander- and Implant-Associated Infections in Breast Reconstruction
    Ozturk, Can
    Ozturk, Cemile N.
    Platek, Mary
    Soucise, Allison
    Laub, Peter
    Morin, Nabiha
    Lohman, Robert
    Moon, Wong
    AESTHETIC PLASTIC SURGERY, 2020, 44 (06) : 2075 - 2082
  • [10] A novel rodent model of chronic spinal implant-associated infection
    DeMourdant, Trevor
    Rajkovic, Christian J.
    Tracz, Jovanna A.
    Perdomo-Pantoja, Alexander
    Judy, Brendan F.
    Hernandez, Vaughn N.
    Lin, Jessica
    Lazzari, Julianna L.
    Dikeman, Dustin A.
    Archer, Nathan K.
    Davis, Kimberly M.
    Gordon, Oren
    Witham, Timothy F.
    SPINE JOURNAL, 2023, 23 (09): : 1389 - 1399