The risk of wound infection in lumbar disk surgery

A number of questions were left unanswered by the empirical success of a 15-year regimen of prophylactic antibiotics in preventing postoperative sepsis at three community hospitals. Although intraoperative cephalosporins have eliminated the morbidity of primary wound infection, the susceptibility to these agents of nosocomial flora has fallen considerably. The principles of antimicrobial prophylaxis have been established, but the debate over the importance of meticulous aseptic technique versus prophylactic antibiotics goes on. We investigated the microbiologic factors in lumbar disk surgery at Nyack Hospital over one year to study (a) potential sources of random contamination, (b) the flora of the operating room, and (c) the efficacy of various aspects of antiseptic routine.