Suppr超能文献

脊柱手术后手术部位感染管理中植入物的保留或取出

Implant Retention or Removal for Management of Surgical Site Infection After Spinal Surgery.

作者信息

Agarwal Aakash, Kelkar Amey, Agarwal Ashish G, Jayaswal Daksh, Schultz Christian, Jayaswal Arvind, Goel Vijay K, Agarwal Anand K, Gidvani Sandeep

机构信息

University of Toledo, Toledo, OH, USA.

Primus Super Speciality Hospital, New Delhi, India.

出版信息

Global Spine J. 2020 Aug;10(5):640-646. doi: 10.1177/2192568219869330. Epub 2019 Aug 11.

Abstract

STUDY DESIGN

A literature review.

OBJECTIVE

To summarize the implant removal rate, common bacterial organisms found, time of onset, ratio of superficial to deep infection, and regurgitating the prevalence among all the retrospective and prospective studies on management and characterization of surgical site infections (SSIs).

METHODS

PubMed was searched for articles published between 2000 and 2018 on the management or characterization of SSIs after spinal surgery. Only prospective and retrospective studies were included.

RESULTS

A total of 49 articles were found relevant to the objective. These studies highlighted the importance of implant removal to avoid recurrence of SSI. The common organisms detected were methicillin-resistant , methicillin-resistant , , , and , with prevalence of 1% to 15%. A major proportion of all were deep SSI, with minority reporting on late-onset SSI.

CONCLUSION

Long-term antibiotics administration, and continuous irrigation and debridement were common suggestion among the authors; however, the key measure undertaken or implied by most authors to avoid risk of recurrence was removal or replacement of implants for late-onset SSI.

摘要

研究设计

文献综述。

目的

总结在所有关于手术部位感染(SSI)管理与特征的回顾性和前瞻性研究中,植入物取出率、常见细菌种类、发病时间、浅表感染与深部感染的比例以及反流的发生率。

方法

在PubMed上搜索2000年至2018年间发表的关于脊柱手术后SSI管理或特征的文章。仅纳入前瞻性和回顾性研究。

结果

共找到49篇与该目的相关的文章。这些研究强调了取出植入物以避免SSI复发的重要性。检测到的常见病原体为耐甲氧西林金黄色葡萄球菌、耐甲氧西林表皮葡萄球菌、大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌,发生率为1%至15%。所有感染中大部分为深部SSI,少数报告了迟发性SSI。

结论

作者们普遍建议长期使用抗生素以及持续冲洗和清创;然而,大多数作者采取或暗示的避免复发风险的关键措施是针对迟发性SSI取出或更换植入物。

相似文献

1
Implant Retention or Removal for Management of Surgical Site Infection After Spinal Surgery.
Global Spine J. 2020 Aug;10(5):640-646. doi: 10.1177/2192568219869330. Epub 2019 Aug 11.
4
Surgical Site Infections Caused by Methicillin-resistant Staphylococcus epidermidis After Spinal Instrumentation Surgery.
Spine (Phila Pa 1976). 2017 Apr 1;42(7):525-530. doi: 10.1097/BRS.0000000000001792.
5
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine. 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.SPINE14559. Epub 2015 Apr 10.
6
Epidemiology of Deep Surgical Site Infections After Pediatric Spinal Fusion Surgery.
Spine (Phila Pa 1976). 2017 Feb;42(3):E163-E168. doi: 10.1097/BRS.0000000000001735.
7
Burden of Surgical Site Infections Associated with Arthroplasty and the Contribution of Staphylococcus aureus.
Surg Infect (Larchmt). 2016 Feb;17(1):78-88. doi: 10.1089/sur.2014.246. Epub 2015 Sep 25.
9
Management of late-onset deep surgical site infection after instrumented spinal surgery.
BMC Surg. 2018 Dec 22;18(1):121. doi: 10.1186/s12893-018-0458-4.

引用本文的文献

1
Late Complications and Adverse Events in Adult Deformity Surgery: A Narrative Review of Event Types, Prevalence, and Information Gaps.
Global Spine J. 2025 Jul;15(3_suppl):159S-171S. doi: 10.1177/21925682251342556. Epub 2025 Jul 9.
2
Injectable alginate/collagen clindamycin hydrogel for treatment of surgical site infections.
Sci Rep. 2025 Mar 7;15(1):7964. doi: 10.1038/s41598-025-92294-0.
4
Synthesis and evaluation of a novel vancomycin-infused, biomimetic bone graft using a rat model of spinal implant-associated infection.
N Am Spine Soc J. 2024 Apr 9;18:100323. doi: 10.1016/j.xnsj.2024.100323. eCollection 2024 Jun.
5
Implant Surface Technologies to Prevent Surgical Site Infections in Spine Surgery.
Int J Spine Surg. 2023 Dec 27;17(S3):S75-S85. doi: 10.14444/8563.
6
Global research characteristics and trends of infection after spinal implant surgery: a bibliometric analysis.
Ann Transl Med. 2023 Mar 31;11(6):255. doi: 10.21037/atm-21-5044. Epub 2023 Jan 14.
7
The Current Knowledge on the Pathogenesis of Tissue and Medical Device-Related Biofilm Infections.
Microorganisms. 2022 Jun 21;10(7):1259. doi: 10.3390/microorganisms10071259.
9
Biofilm-Related Infections in Gram-Positive Bacteria and the Potential Role of the Long-Acting Agent Dalbavancin.
Front Microbiol. 2021 Oct 22;12:749685. doi: 10.3389/fmicb.2021.749685. eCollection 2021.
10
Postoperative Management Strategy of Surgical Site Infection following Lumbar Dynesys Dynamic Internal Fixation.
Pain Res Manag. 2021 Oct 7;2021:2262837. doi: 10.1155/2021/2262837. eCollection 2021.

本文引用的文献

1
Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review.
Spine Surg Relat Res. 2019 Jun 21;4(2):111-116. doi: 10.22603/ssrr.2019-0038. eCollection 2020.
2
High frequency of low-virulent microorganisms detected by sonication of pedicle screws: a potential cause for implant failure.
J Neurosurg Spine. 2019 May 28;31(3):424-429. doi: 10.3171/2019.1.SPINE181025. Print 2019 Sep 1.
3
Harboring Contaminants in Repeatedly Reprocessed Pedicle Screws.
Global Spine J. 2019 Apr;9(2):173-178. doi: 10.1177/2192568218784298. Epub 2018 Jun 25.
4
Efficacy of Intraoperative Implant Prophylaxis in Reducing Intraoperative Microbial Contamination.
Global Spine J. 2019 Feb;9(1):62-66. doi: 10.1177/2192568218780676. Epub 2018 Jun 12.
6
Management of late-onset deep surgical site infection after instrumented spinal surgery.
BMC Surg. 2018 Dec 22;18(1):121. doi: 10.1186/s12893-018-0458-4.
7
Prognosis of deep infection in spinal surgery using implants, treated by retention, removal of bone graft and lengthy antibiotherapy.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2019 Jan-Feb;63(1):7-11. doi: 10.1016/j.recot.2018.10.001. Epub 2018 Dec 7.
8
Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine Surgery.
Global Spine J. 2018 Oct;8(7):761-765. doi: 10.1177/2192568218762380. Epub 2018 Apr 24.
10
Revision spine surgery in patients without clinical signs of infection: How often are there occult infections in removed hardware?
Eur Spine J. 2018 Oct;27(10):2491-2495. doi: 10.1007/s00586-018-5654-5. Epub 2018 Jun 20.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验