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Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery
INTRODUCTION: Reported rate of infections after lumbar discectomy is 1%–15 %. This complication may result in disability or even the death. AIM: The aim of the study is to assess the rate of infection associated with lumbar discectomies when combined systemic and local antibiotic prophylaxis was emp...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AVICENA, d.o.o., Sarajevo
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314156/ https://www.ncbi.nlm.nih.gov/pubmed/25685087 http://dx.doi.org/10.5455/msm.2014.26.398-400 |
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author | Kërveshi, Armend Halili, Nehat Kastrati, Bujar Qosja, Faik Kabashi, Serbeze Muçaj, Sefedin |
author_facet | Kërveshi, Armend Halili, Nehat Kastrati, Bujar Qosja, Faik Kabashi, Serbeze Muçaj, Sefedin |
author_sort | Kërveshi, Armend |
collection | PubMed |
description | INTRODUCTION: Reported rate of infections after lumbar discectomy is 1%–15 %. This complication may result in disability or even the death. AIM: The aim of the study is to assess the rate of infection associated with lumbar discectomies when combined systemic and local antibiotic prophylaxis was employed. PATIENTS AND METHODS: In this retrospective study we analyzed all patients operated for herniated lumbar disc from 2009 -2012 in our institute. Beside of receiving systemic prophylaxis with 2g of Cefazoline, all patients had their operative field irrigated at the end of operation with Amikacin sulfate injection. Wound was considered infected when local and systemic signs of infection were revealed and were associated with elevated ESR, leukocytosis and elevated CRP. Assessment of infection is done by neurosurgeon during the hospitalization and later at outpatient’s clinic along postoperative course of three months. RESULTS: A total of 604 patients were operated, of those 285 patients (47.2 %) females and 319 males (52.8 %), 12 patients were operated on two levels (1.98 %). Average patient age was 32.5 years (range 20–65 years) Localization of herniated disc was: in L/2-L/3 20 patients or 3.3 %, the L/3-L/4 level 42 patients or 7 % , the L/4 -L /5 262 patients or 43.3 % at the level L/V- S/1 280 patients or 46.3 %. Three patients (0.49%) developed wound infection, two of them superficial infection only with local signs: local pain, redness and leakage. They were treated with oral antibiotics. One with deep wound infection. He presented with local and systemic signs and treated with i.v antibiotics. All the cultures from wound swab revealed staphylococcus aureus. CONCLUSION: Prophylaxis with systemic antibiotic (Cefazoline 2.0) intravenous administration 30 minutes before the incision and irrigation of operative field with local antibiotic Amikacine sulfate at the end of procedure reduces the infection rate in patients operated for herniated lumbar disc when compared with systemic antibiotic prophylaxis only. |
format | Online Article Text |
id | pubmed-4314156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | AVICENA, d.o.o., Sarajevo |
record_format | MEDLINE/PubMed |
spelling | pubmed-43141562015-02-13 Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery Kërveshi, Armend Halili, Nehat Kastrati, Bujar Qosja, Faik Kabashi, Serbeze Muçaj, Sefedin Mater Sociomed Professional Paper INTRODUCTION: Reported rate of infections after lumbar discectomy is 1%–15 %. This complication may result in disability or even the death. AIM: The aim of the study is to assess the rate of infection associated with lumbar discectomies when combined systemic and local antibiotic prophylaxis was employed. PATIENTS AND METHODS: In this retrospective study we analyzed all patients operated for herniated lumbar disc from 2009 -2012 in our institute. Beside of receiving systemic prophylaxis with 2g of Cefazoline, all patients had their operative field irrigated at the end of operation with Amikacin sulfate injection. Wound was considered infected when local and systemic signs of infection were revealed and were associated with elevated ESR, leukocytosis and elevated CRP. Assessment of infection is done by neurosurgeon during the hospitalization and later at outpatient’s clinic along postoperative course of three months. RESULTS: A total of 604 patients were operated, of those 285 patients (47.2 %) females and 319 males (52.8 %), 12 patients were operated on two levels (1.98 %). Average patient age was 32.5 years (range 20–65 years) Localization of herniated disc was: in L/2-L/3 20 patients or 3.3 %, the L/3-L/4 level 42 patients or 7 % , the L/4 -L /5 262 patients or 43.3 % at the level L/V- S/1 280 patients or 46.3 %. Three patients (0.49%) developed wound infection, two of them superficial infection only with local signs: local pain, redness and leakage. They were treated with oral antibiotics. One with deep wound infection. He presented with local and systemic signs and treated with i.v antibiotics. All the cultures from wound swab revealed staphylococcus aureus. CONCLUSION: Prophylaxis with systemic antibiotic (Cefazoline 2.0) intravenous administration 30 minutes before the incision and irrigation of operative field with local antibiotic Amikacine sulfate at the end of procedure reduces the infection rate in patients operated for herniated lumbar disc when compared with systemic antibiotic prophylaxis only. AVICENA, d.o.o., Sarajevo 2014-12 2014-12-14 /pmc/articles/PMC4314156/ /pubmed/25685087 http://dx.doi.org/10.5455/msm.2014.26.398-400 Text en Copyright: © AVICENA http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Professional Paper Kërveshi, Armend Halili, Nehat Kastrati, Bujar Qosja, Faik Kabashi, Serbeze Muçaj, Sefedin Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery |
title | Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery |
title_full | Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery |
title_fullStr | Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery |
title_full_unstemmed | Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery |
title_short | Local Irrigation of the Surgical Field with Antibiotics in the End of Procedure Reduces the Infection Rate in Herniated Lumbar Disc Surgery |
title_sort | local irrigation of the surgical field with antibiotics in the end of procedure reduces the infection rate in herniated lumbar disc surgery |
topic | Professional Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314156/ https://www.ncbi.nlm.nih.gov/pubmed/25685087 http://dx.doi.org/10.5455/msm.2014.26.398-400 |
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