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- Title
Does the use of intrawound povidone-iodine irrigation and local vancomycin powder impact surgical site infection rate in adolescent idiopathic scoliosis surgery?
- Authors
Mallet, Cindy; Meissburger, Victor; Caseris, Marion; Happiette, Adèle; Chinnappa, Jason; Bonacorsi, Stéphane; Simon, Anne-Laure; Ilharreborde, Brice
- Abstract
Purpose: Surgical site infection (SSI) is a major complication after adolescent idiopathic scoliosis (AIS) surgery, with an incidence ranging from 0.5 to 7%. Intraoperative wound decontamination with povidone-iodine (PVP-I) irrigation and/or vancomycin powder in adult spinal surgery has gained attention in the literature with controversial results. The aim of this study was to investigate the impact of using intrawound PVP-I irrigation and local vancomycin powder (LVP) on the incidence of early SSI in AIS surgery. Methods: All AIS patients who underwent posterior spinal fusion between October 2016 and December 2019 were retrospectively reviewed. The incidence of early SSI was reported and compared between 2 groups defined by the treating spinal surgeons' preferences: group 1—intrawound irrigation with 2L of PVP-I and application of 3 g LVP before closure and control group 2—patients that did not receive either of these measures. Results: Nine early cases of SSI (2.9%) were reported among the 307 AIS posterior spinal fusion patients. Incidence of SSI in group 1 (2/178 = 1.1%) was significantly lower than in group 2 (7/129 = 5.4%; p = 0.04). There were no adverse reactions to the use of PVP-I and LVP in our study. At latest follow-up, rate of surgical revision for mechanical failure with pseudarthrosis was significantly lower in group 1 (2/178 = 1.1%) than in group 2 (9/129 = 7.0%; p = 0.01). Conclusion: Intraoperative use of intrawound PVP-I irrigation and vancomycin powder is associated with a significant reduction of early SSI after AIS spine surgery. Level of evidence IV: Retrospective study.
- Subjects
ADOLESCENT idiopathic scoliosis; SURGICAL site infections; SPINAL surgery; IRRIGATION (Medicine); VANCOMYCIN; POVIDONE-iodine
- Publication
European Spine Journal, 2022, Vol 31, Issue 11, p3020
- ISSN
0940-6719
- Publication type
Article
- DOI
10.1007/s00586-022-07340-6