Reducing Surgical Site Infections in Spine Tumor Surgery: A Comparison of Three Methods

Area of Science:

• Neurosurgery
• Oncology
• Infectious Disease

Background:

• Increasing cancer prevalence and aging populations lead to more spine tumor surgeries.
• Surgical site infections (SSIs) are a common complication of spine tumor surgery.
• Effective methods to decrease SSIs are crucial for patient safety.

Purpose of the Study:

• To evaluate and compare the effectiveness of different methods in reducing SSIs after spine tumor surgery.
• To identify factors associated with SSIs in this patient population.

Main Methods:

• A single-institution case-control series included patients undergoing spine tumor surgery from June 2003 to October 2018.
• Patients were grouped into: Betadine irrigation and intrawound vancomycin powder (BIVP), intrawound vancomycin powder only (IVP), and neither (NONE).
• The primary outcome measured was SSIs and wound complications.

Main Results:

• The BIVP group showed a significantly lower infection rate (2.7%) compared to the IVP (12.8%) and NONE (13%) groups (P=0.04).
• Elevated BMI (OR 1.14, P=0.02) and preoperative radiation treatment were associated with higher SSI rates.
• BIVP demonstrated a protective effect against SSIs (P=0.02, OR 0.02).

Conclusions:

• Betadine irrigation and intrawound vancomycin powder (BIVP) significantly decreases SSI rates in spine tumor surgery.
• The administration of BIVP is a straightforward and effective method to reduce SSIs.
• Implementing BIVP can enhance patient safety and surgical outcomes.