Which method is the most effective for preventing postoperative infection in spinal surgery?

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Biomaterials Science

Background:

• Spinal surgeries with instrumentation carry a risk of postoperative infection.
• Various methods are employed to mitigate infection rates.
• The most effective preventative strategy remains under investigation.

Purpose of the Study:

• To compare the efficacy of antibiotic prophylaxis, silver-plated screws, and local rifamycin application in preventing surgical site infections.
• To determine the optimal method for reducing infection risk in instrumented spinal surgery.

Main Methods:

• An experimental animal model using 50 Wistar albino rats was employed.
• Rats were divided into five groups: control, titanium screw with S. aureus, rifamycin with screw and S. aureus, cefazolin with screw and S. aureus, and silver-plated screw with S. aureus.
• Surgical site infection was assessed 15 days post-operation by culturing tissue and screw samples for Staphylococcus aureus.

Main Results:

• Staphylococcus aureus showed intensive growth in the control (Group 2) and cefazolin (Group 4) groups.
• No significant bacterial growth was observed in the rifamycin (Group 3) or control (Group 1) groups.
• Eight of ten samples showed intensive growth in the silver-plated screw group (Group 5).

Conclusions:

• Local rifamycin application to the surgical site is a highly effective method for preventing Staphylococcus aureus infections during instrumented spinal surgery.
• Rifamycin demonstrates superior efficacy compared to systemic antibiotic prophylaxis and silver-plated screws in this model.
• This finding supports the use of local rifamycin as a key strategy in infection control for spinal instrumentation procedures.