An International Survey to Understand Infection Control Practices for Spinal Cord Stimulation

Area of Science:

• Neurosurgery
• Infectious Disease Prevention
• Healthcare Policy

Background:

• Surgical site infections (SSIs) following spinal cord stimulation (SCS) procedures contribute to significant morbidity and healthcare costs.
• Existing research on preventing SCS-specific SSIs is limited, necessitating an examination of current practices.

Purpose of the Study:

• To assess current infection control practices for SCS trials and implants internationally.
• To compare reported practices against established evidence-based recommendations from organizations like the CDC, NICE, and SCIP.

Main Methods:

• An international survey with 33 questions on infection control policies was distributed online.
• Physician responses to 15 key questions aligned with CDC, NICE, and SCIP recommendations were classified as compliant or noncompliant.
• Data were analyzed based on geographic location, practice type, and procedural volume.

Main Results:

• Low compliance rates (≥80%) were observed for only four out of 15 infection control practices.
• Significant noncompliance was noted in areas including antibiotic dosing, hair removal, gloving, surgical dressings, antiseptic selection, and postoperative antibiotic use.
• Variations in practices were identified across different geographic regions and practice types.

Conclusions:

• The survey reveals critical insights into current SCS infection control measures, identifying areas for improvement.
• There is a clear need for enhanced education and development of specific SCS infection control policies for physicians performing these procedures.