Madariaga Maria Cecilia, O'Malley Nicholas A, Groff Hannah, Alben Matthew, Papalia Aidan, Fogel Joshua, Thompson Jeffrey, Apazidis Alexios
Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, NY 11554.
State University at Buffalo, Department of Orthopedic Surgery, Buffalo, NY.
N Am Spine Soc J. 2024 Jul 1;19:100514. doi: 10.1016/j.xnsj.2024.100514. eCollection 2024 Sep.
Surgical site infection (SSI) is a common yet serious complication of cervical spine surgery. While initially thought to be clinically insignificant, ( is an important cause of infection. The purpose of this study was to investigate the ability of a hydrogen peroxide (HO) application during standard presurgical skin preparation to reduce the burden of in patients undergoing cervical spine surgery.
This was a retrospective review of prospectively collected data. Subjects were randomly assigned to either standard surgical preparation plus HO (experimental) or without HO (control). Prescrub, postscrub, and dermal cultures were obtained to assess the burden after cultures on an aerobic and anaerobic growth medium were held for 21 days. Multivariate analysis was conducted to determine factors associated with presence of . Outcome measures included the results of intraoperative cultures and the development of a SSI within 90 days postoperatively.
Patients (n=86) undergoing elective 2- or 3-level fusion via anterior approach were included. Prior to application of the antiseptic solution, 65% (28/43) of the experimental cohort and 77% (33/43) of the control cohort had positive cultures (p=.34). Following application of antiseptic solution, there were no differences in positive culture rates between the experimental and control cohorts in the epidermal (30% vs. 28%, p=1.00) or dermal (40% vs. 42%, p=1.00) cultures. No differences in the rates of eradication from preantiseptic to postantiseptic application occurred for epidermal (p=1.00) or dermal (p=1.00) skin layers. None of the factors were associated with positive epidermal cultures on multivariable logistic regression analysis (p>.05).
While there is potential for HO to reduce the positive culture rate of in cervical spine patients, no difference was seen when compared to standard surgical skin preparation.
手术部位感染（SSI）是颈椎手术常见且严重的并发症。虽然最初认为其在临床上无显著意义，但（此处原文缺失部分内容）是感染的重要原因。本研究的目的是调查在标准术前皮肤准备过程中应用过氧化氢（HO）能否减轻颈椎手术患者的（此处原文缺失部分内容）负担。
这是一项对前瞻性收集数据的回顾性研究。受试者被随机分为标准手术准备加HO组（实验组）或不加HO组（对照组）。在需氧和厌氧生长培养基上培养21天后，获取术前擦皮、术后擦皮和真皮培养物以评估（此处原文缺失部分内容）负担。进行多变量分析以确定与（此处原文缺失部分内容）存在相关的因素。结果指标包括术中培养结果和术后90天内手术部位感染的发生情况。
纳入了86例接受选择性前路2或3节段融合术的患者。在应用抗菌溶液之前，实验组65%（28/43）和对照组77%（33/43）的（此处原文缺失部分内容）培养结果为阳性（p = 0.34）。应用抗菌溶液后，实验组和对照组在表皮（30%对28%，p = 1.00）或真皮（40%对42%，p = 1.00）培养中的（此处原文缺失部分内容）阳性培养率无差异。从术前擦皮到术后擦皮应用，表皮（p = 1.00）或真皮（p = 1.00）层的（此处原文缺失部分内容）清除率无差异。在多变量逻辑回归分析中，没有因素与表皮（此处原文缺失部分内容）阳性培养相关（p>0.05）。
虽然HO有降低颈椎手术患者（此处原文缺失部分内容）阳性培养率的潜力，但与标准手术皮肤准备相比未见差异。
