Use of an intraoperative sodium oxychlorosene-based infection prevention protocol to safely decrease postoperative...

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Surgical Outcomes

Background:

• Postoperative infection is a significant complication following spinal surgery.
• Existing infection prevention protocols have shown success but often exclude trauma patients.
• The efficacy of intraoperative infection prevention in instrumented spinal surgery requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of a multi-institutional, intraoperative sodium oxychlorosene-based infection prevention protocol.
• To determine the impact of this protocol on reducing infection rates in patients undergoing instrumented spinal surgery.
• To assess the protocol's effect on other postoperative outcomes and patient quality of life.

Main Methods:

• Retrospective analysis of 5047 patients undergoing posterior instrumented spinal fusion across two Level I trauma centers.
• Infection rates were compared before and after the implementation of the sodium oxychlorosene protocol.
• Prospective data collection on quality of life measures for patients undergoing surgery after protocol implementation.

Main Results:

• The infection rate decreased significantly from 3.5% before the protocol to 1.2% after implementation (p < 0.001).
• No significant difference was observed in sterile seroma rates between pre- and post-protocol groups (0.7% vs. 0.7%).
• Two of ten patients who developed deep wound infections died from infection-related complications, highlighting a potential mortality risk.

Conclusions:

• An intraoperative sodium oxychlorosene-based protocol effectively reduces infection rates in spinal surgery.
• The protocol demonstrated no adverse impact on other postoperative metrics, such as sterile seroma formation.
• Postoperative wound infections following spinal surgery may be linked to increased mortality.