Spinal gunshot wounds and infection: a multicenter cohort study

Area of Science:

• Trauma Surgery
• Infectious Diseases
• Orthopedic Surgery

Background:

• Spinal gunshot wounds carry a risk of infection, yet standardized management guidelines are lacking.
• Limited evidence necessitates further research into optimal prophylactic antibiotic strategies.

Purpose of the Study:

• To analyze infectious complications following civilian gunshot wounds to the spine.
• To investigate the association between prophylactic antibiotic type, duration, and infection development.

Main Methods:

• Retrospective cohort study of 292 adult civilian patients treated for spinal gunshot wounds (2014-2022).
• Analysis of demographic, clinical, injury, and treatment characteristics, including infectious complications.
• Evaluation of antibiotic prophylaxis type and duration.

Main Results:

• The overall incidence of infectious complications was 6.8%, with spinal infections occurring in 1.0% of patients.
• Prolonged antibiotic prophylaxis was associated with dirty wounds and high-velocity injuries but did not decrease spinal infection rates.
• Adult males (86.0%) with a mean age of 32.6 years were the primary demographic affected, with thoracic and lumbosacral spine injuries being most common.

Conclusions:

• Spinal infections following gunshot wounds to the spine have a low incidence (1%).
• Prolonged antibiotic prophylaxis does not appear to reduce the risk of spinal infectious complications.
• Development of standardized guidelines for antibiotic prophylaxis in spinal gunshot wounds is crucial for optimizing patient care.