De Luna Vincenzo, Mancini Federico, De Maio Fernando, Bernardi Gabriele, Ippolito Ernesto, Caterini Roberto
Department of Orthopaedic Surgery, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Adv Orthop. 2017;2017:7218918. doi: 10.1155/2017/7218918. Epub 2017 Oct 2.
Deep wound infection in spine surgery is a debilitating complication for patients and increases costs. The objective of this prospective study was to evaluate the efficacy of wound pulse irrigation with a dilute povidone-iodine solution in the prevention of surgical site infection.
50 patients undergoing spinal surgery were randomly divided into two groups (A and B) of 25 patients each. In group A, wounds were irrigated with dilute (3%) povidone-iodine solution through a low-pressure pulsatile device. In group B, wounds were irrigated with saline solution through a bulb syringe. In both groups, specimens for bacterial culture were harvested from surgical site before and after irrigation.
In group A, no surgical site infection occurred; in group B, deep wound infection was observed in 3 patients. In both groups, before irrigation some cultures have been found positive for bacterial contamination.
Our study seems to support the idea that low-pressure pulsating lavage of surgical wounds with povidone-iodine diluted to a nontoxic concentration of 3% is an effective therapeutic adjunct measure to prevent surgical site infection in spine surgery. However, the number of the enrolled patients is small and a significant statistical analysis is not practicable. This trial is registered with NCT03249363.
脊柱手术中的深部伤口感染对患者来说是一种使人衰弱的并发症，且会增加费用。这项前瞻性研究的目的是评估用稀释的聚维酮碘溶液进行伤口脉冲冲洗在预防手术部位感染方面的疗效。
50例接受脊柱手术的患者被随机分为两组（A组和B组），每组25例。A组通过低压脉冲装置用稀释的（3%）聚维酮碘溶液冲洗伤口。B组通过球囊注射器用生理盐水冲洗伤口。两组在冲洗前后均从手术部位采集细菌培养标本。
A组未发生手术部位感染；B组有3例患者发生深部伤口感染。两组在冲洗前均发现一些培养物存在细菌污染阳性。
我们的研究似乎支持这样一种观点，即用稀释至无毒浓度3%的聚维酮碘对手术伤口进行低压脉冲冲洗是预防脊柱手术中手术部位感染的一种有效的辅助治疗措施。然而，纳入的患者数量较少，无法进行有统计学意义的分析。该试验已在ClinicalTrials.gov注册，注册号为NCT03249363。
