Bacterial wound contamination during simple and complex spinal procedures. A prospective clinical study

Area of Science:

• Spinal Surgery
• Infectious Disease
• Inflammatory Markers

Background:

• Spinal procedures carry a risk of intraoperative contamination.
• C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are used to detect postoperative infections.
• The association between surgical site contamination and clinical infection signs, based on inflammatory markers, requires further investigation.

Purpose of the Study:

• To assess the link between surgical site contamination and postoperative infection development in spinal surgery.
• To monitor CRP and ESR levels and correlate them with surgical factors.
• To investigate the relationship between inflammatory marker values, surgical duration, procedure type, and contamination.

Main Methods:

• Prospective clinical study involving 40 patients undergoing spinal procedures.
• Patients were divided into two groups: simple discectomy (Group A) and complex decompression/fusion (Group B).
• Intraoperative cultures, CRP, and ESR measurements were performed, with follow-up for an average of 26.7 months.

Main Results:

• 20% of patients had positive intraoperative cultures; no significant correlation with surgery duration.
• No patients with positive cultures developed clinical infection signs; no additional antibiotics were needed.
• CRP and ESR levels were significantly higher in complex procedures (Group B) than in simple ones (Group A).

Conclusions:

• Intraoperative contamination is possible in both simple and complex spinal surgeries.
• Antibiotic treatment is not required for intraoperative contamination if no postoperative infection signs are present.
• Postoperative CRP and ESR kinetics are similar in contaminated and uncontaminated cases; higher levels indicate complex procedures.