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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Modulation of Surgical Site Infection Risk in Spinal and Thoracic Surgeries Through Operative Parameters: A Narrative

Joanna Suszczyńska1, Michał Grabala1, Paweł Grabala2

  • 12nd Clinical Department of General and Gastroenterogical Surgery, Medical University of Bialystok, ul. M. Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland.

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Surgical site infections (SSIs) after spine and thoracic surgery can be reduced by optimizing operative factors and implementing evidence-based wound care. Strategies include timely antibiotic prophylaxis, targeted negative-pressure wound therapy (NPWT), and intrawound vancomycin.

Keywords:
antibiotic prophylaxisnegative-pressure wound therapyrisk factorsspinal surgerysurgical site infectionthoracic surgery

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Area of Science:

  • Surgical Infection Prevention
  • Wound Management
  • Thoracic and Spinal Surgery

Background:

  • Surgical site infections (SSIs) complicate spinal and thoracic procedures, increasing morbidity and hospital stays.
  • Risk factors include diabetes, obesity, smoking, long operative times, and hardware use.
  • Evidence-based prevention is crucial for high-risk surgical patients.

Purpose of the Study:

  • To review current evidence on SSI incidence, risk factors, and prevention in spinal and thoracic surgery.
  • To synthesize findings on operative parameters, antibiotic prophylaxis, and wound therapies.
  • To inform best practices for reducing SSIs in these patient populations.

Main Methods:

  • Narrative review of studies from PubMed, Scopus, ScienceDirect, Cochrane Library, and Embase (2000-2025).
  • Included peer-reviewed articles on SSI in adult thoracic or spinal surgery patients.
  • Extracted data on operative parameters, antibiotic regimens, NPWT, and outcomes.

Main Results:

  • Longer operative duration (>4h) and greater blood loss (>500mL) significantly increase SSI risk.
  • Prophylactic negative-pressure wound therapy (NPWT) and intrawound vancomycin powder halved deep SSI rates in high-risk patients.
  • Antibiotic prophylaxis within 30 minutes of incision and weight-adjusted dosing in obese patients improved outcomes.

Conclusions:

  • Operative factors are strong predictors of SSI risk.
  • An integrated approach combining optimized antibiotic prophylaxis, risk-stratified NPWT, and surgical technique modification can significantly reduce SSIs.
  • Successful implementation requires institutional commitment and multidisciplinary collaboration.