Spina Nicholas T, Aleem Ilyas S, Nassr Ahmad, Lawrence Brandon D
University of Utah, Salt Lake City, UT, USA.
University of Michigan, Ann Arbor, MI, USA.
Global Spine J. 2018 Dec;8(4 Suppl):31S-36S. doi: 10.1177/2192568217752130. Epub 2018 Dec 13.
Literature review.
A review of the literature identifying preoperative risk factors for developing surgical site infections after spine surgery and discussion of the preventive strategies to minimize risks.
A review of the literature and synthesis of the data to provide an updated review on the preoperative management of surgical site infection.
Preoperative prevention strategies of reducing surgical site infections in spine surgery remains a challenging problem. Careful mitigation of modifiable patient comorbidities, blood glucose control, smoking, obesity, and screening for pathologic microorganisms is paramount to reduce this risk. Individualized antibiotic regimens, skin preparation, and hand hygiene also play a critical role in surgical site infection prevention.
This review of the literature discusses the preoperative preventive strategies and risk management techniques of surgical site infections in spine surgery. Significant decreases in surgical site infections after spine surgery have been noted over the past decade due to increased awareness and implementation of the prevention strategies described in this article. However, it is important to recognize that prevention of surgical site infection requires a system-wide approach that includes the hospital system, the surgeon, and the patient. Continued efforts should focus on system-wide implementation programs including careful patient selection, individualized antibiotic treatment algorithms, identification of pathologic organisms, and preoperative decolonization programs to further prevent surgical site infections and optimize patient outcomes.
文献综述。
回顾文献，确定脊柱手术后手术部位感染的术前危险因素，并讨论将风险降至最低的预防策略。
回顾文献并综合数据，以提供关于手术部位感染术前管理的最新综述。
脊柱手术中减少手术部位感染的术前预防策略仍然是一个具有挑战性的问题。谨慎减轻可改变的患者合并症、控制血糖、戒烟、控制肥胖以及筛查病原微生物对于降低这种风险至关重要。个体化抗生素方案、皮肤准备和手部卫生在预防手术部位感染方面也起着关键作用。
本文献综述讨论了脊柱手术中手术部位感染的术前预防策略和风险管理技术。由于对本文所述预防策略的认识提高和实施，过去十年脊柱手术后手术部位感染显著减少。然而，重要的是要认识到预防手术部位感染需要一种全系统的方法，包括医院系统、外科医生和患者。持续的努力应集中在全系统实施计划上，包括仔细选择患者、个体化抗生素治疗方案、识别病原生物以及术前去定植计划，以进一步预防手术部位感染并优化患者预后。
