Agarwal Aakash, Kelkar Amey, Agarwal Ashish G, Jayaswal Daksh, Schultz Christian, Jayaswal Arvind, Goel Vijay K, Agarwal Anand K, Gidvani Sandeep
University of Toledo, Toledo, OH, USA.
Primus Super Speciality Hospital, New Delhi, India.
Global Spine J. 2020 Aug;10(5):640-646. doi: 10.1177/2192568219869330. Epub 2019 Aug 11.
A literature review.
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).
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.
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.
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.
文献综述。
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。
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。
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。
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。