Clinical Analysis of Postoperative Wound Infections
after Spinal Instrumentation

Keimyung Medical Journal 2004;23(2):103-110.

Clinical Analysis of Postoperative Wound Infections after Spinal Instrumentation

척추고정술 후 발생한 창상감염의 임상적 분석

김인수

Abstract

Postoperative wound infection remains a troublesome and not uncommon complication after spinal instrumentation. This study; representing a surgeon’s 10-year experience with postoperative infection at one institution; was performed to evaluate the risk factors; diagnosis; clinical manifestations; effective managements; and prognostic factors among patients with postoperative wound infection after spinal instrumentation. Of 418 operative procedures; 14 cases (mean age; 57 years) of wound infection were identified; yielding and overall infection ratio of 3.35%. Eight among 14 cases had significant preoperative risk factors (diabetes mellitus; smoker; obesity; alcoholism). Wound discharge was the most common presenting problem; with 92.8% experiencing this symptom. The most common cultured organism was Staphylococcus aureus; which was found in the wounds of eight patients(57.1%). All patients could be discharged after infection control without sequelae. C-reactive protein (CRP) was more correlated with clinical outcomes than other laboratory findings. Although wound infection after spinal instrumentation is a potentially devastating problem; this study suggests that aggressive surgical management; including repeated debridement followed by delayed closures; can result in preservation of instrumentation for fusion and acceptable postoperative outcomes.

Key Words: Postoperative wound infection, Spinal instrumentation