One or Two Drains for the Treatment of Surgical Site Infections After Lumbar Spine Surgery

Optimal drainage after débridement for treating postoperative surgical site infection (SSI) is controversial. We compared single-tube drainage with double-tube drainage.

We retrospectively analyzed 1125 patients with lumbar degenerative disease who underwent lumbar surgery. Postoperative SSI was diagnosed in 26 patients, and these patients were divided into 2 groups: single-tube drainage group (1 drain) and double-tube drainage group (2 drains).

The 26 adult patients (17 women and 9 men) with postoperative SSI after lumbar surgery (26/1125 [2.3%]) were treated with débridement. There were no significant differences in patient age, sex, body mass index, mean number of pedicle screws, operative time, amount of bleeding, and drainage between the 2 groups. There were no significant differences between groups in administration of antibiotics (P > 0.05). Bacterial cultures were routinely performed in all 26 cases of SSI; 80.7% (21/26) of patients had a positive culture. Staphylococcus species, including predominantly S. aureus, methicillin-resistant S. aureus, and S. epidermidis, were the most common pathogens, followed by Escherichia coli, Acinetobacter, Klebsiella pneumoniae, and Enterococcus faecalis. There were no significant differences in drainage efficiency between the 1 drain and 2 drains groups (P > 0.05).

There were no significant differences between the 1 drain and 2 drains groups in surgery-related and patient-related risk factors, pathogenic bacteria and antibiotic therapy, laboratory tests results, or drainage efficiency and time. However, patients in the 1 drain group exhibited better clinical outcome and shorter hospital stay.