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Efficacy of local Dexamethasone used in Operation Area after Lumbar Microdiscectomy on postoperative infection
Murat Yucel1, Eyup Cetin2, Ozkan Arabaci3
1Murat Yucel, Faculty of Medicine, Department of Neurosurgery, Yalova University, Yalova, Turkey.
Background & Objective:
Postoperative wound infection, although relatively uncommon, remains a significant complication of spinal surgery. Preventive strategies must therefore be rigorously implemented before, during and after surgery. While local steroid administration is frequently employed during lumbar microdiscectomy to reduce neural edema, limited evidence exists regarding its effects on infection rates. This study aimed to evaluate the impact of locally applied dexamethasone in the surgical site on the incidence of postoperative infection.
Methodology:
This retrospective observational study was conducted between January 2020 to December 2022 at the Neurosurgery Departments of Van Yüzüncü Yıl University Medical School. A total of 200 patients (89 females, 111 males) who underwent lumbar microdiscectomy were included. Patients were divided into two groups: those who received local dexamethasone (8 mg) applied to the surgical site (n = 54) and those who did not (n = 146). No systemic steroids were used in either group.
Results:
In the dexamethasone group, no patients developed superficial wound infection, whereas 11 patients in the non-dexamethasone group did. No deep infection was observed in either group. Although the reduction in infection was not statistically significant, the local infection rate was significantly higher in the non-dexamethasone group (p < 0.05).
Conclusion:
Local administration of dexamethasone following lumbar microdiscectomy was associated with a lower rate of superficial wound infection compared with no dexamethasone use. Postoperative infection remains an important clinical concern in spinal surgery, and careful attention to perioperative preventive measures is warranted.
Insights
Local dexamethasone application after lumbar microdiscectomy may reduce superficial surgical site infections. This study suggests a potential benefit in preventing postoperative wound complications in spinal surgery patients.
Area of Science:
- Neurosurgery
- Surgical Infection Prevention
Background:
- Postoperative wound infection is a significant complication of spinal surgery.
- Local steroid use, like dexamethasone, is common for neural edema but its effect on infection is unclear.
Purpose of the Study:
- To evaluate the impact of local dexamethasone on postoperative infection rates after lumbar microdiscectomy.
Main Methods:
- Retrospective observational study of 200 patients undergoing lumbar microdiscectomy.
- Two groups: local dexamethasone (n=54) vs. no local dexamethasone (n=146).
- No systemic steroids were administered.
Main Results:
- No superficial wound infections in the dexamethasone group versus 11 in the non-dexamethasone group.
- No deep infections occurred in either group.
- The non-dexamethasone group had a significantly higher local infection rate (p < 0.05).
Conclusions:
- Local dexamethasone administration was associated with a lower superficial wound infection rate.
- Postoperative infection is a concern in spinal surgery, warranting careful perioperative measures.
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