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Surgeon practices regarding infection prevention for pediatric spinal surgery
Michael P Glotzbecker1, Michael G Vitale, Kevin G Shea
1*Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA †Morgan Stanley Children's Hospital of New York, Manhattan, NY ‡Intermountain Orthopaedics Idaho, Boise, ID §Children's Hospital of Philadelphia, Philadelphia, PA.
Journal of Pediatric Orthopedics
|June 19, 2013
Summary
Pediatric spinal surgeons show varied infection prevention methods, indicating a need for evidence-based guidelines to reduce postoperative infections. This variability may reflect suboptimal care and highlights the need for multicenter studies.
Area of Science:
- Orthopedic Surgery
- Pediatric Spine Surgery
- Infection Prevention
Background:
- Postoperative spinal infections pose significant financial and emotional burdens.
- Understanding current infection prevention strategies is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the infection prevention approaches employed by pediatric spinal surgeons.
- To identify variations in current surgical practices.
Main Methods:
- Electronic survey distributed to 277 members of POSNA/SRS.
- 123 responses (44% participation rate) analyzed.
- Participant demographics: 81% academic practice, 82% >10 years in practice.
Main Results:
- 64% of surgeons knew their infection rates (average 1.3% idiopathic, 5.3% neuromuscular).
- Significant variability observed in preoperative protocols (e.g., chlorhexidine use, risk stratification labs, MRSA swabs, urine cultures).
- Antibiotic prophylaxis, skin preparation, vancomycin powder use, and operating room policies varied widely.
Conclusions:
- Substantial variability exists in spinal deformity surgery infection prevention practices.
- This variability may stem from a lack of robust evidence, potentially leading to suboptimal care.
- The findings serve as a foundation for designing multicenter studies to reduce surgical site infections.
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