Does hydrogen peroxide help mitigate the incidence of in cervical spine surgeries?

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.