Surgical site infection after pediatric spinal deformity surgery |
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Authors: | Ying Li Michael Glotzbecker Daniel Hedequist |
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Affiliation: | Department of Orthopaedic Surgery, C.S. Mott Children’s Hospital, 1540 E. Hospital Drive, Ann Arbor, MI 48109 USA ;Department of Orthopaedic Surgery, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115 USA |
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Abstract: | The incidence of surgical site infection (SSI) after spinal deformity surgery for adolescent idiopathic scoliosis ranges from 0.5–6.7%. The risk of infection following spinal fusion in patients with neuromuscular scoliosis is greater, with reported rates of 6.1–15.2% for cerebral palsy and 8–41.7% for myelodysplasia. SSIs result in increased patient morbidity, multiple operations, prolonged hospital stays, and significant financial costs. Recent literature has focused on elucidating the most common organisms involved in SSIs, as well as identifying modifiable risk factors and prevention strategies that may decrease the rates of infection. These include malnutrition, positive urine cultures, antibiotic prophylaxis, surgical site antisepsis, antibiotic-loaded allograft, local application of antibiotics, and irrigation solutions. Acute and delayed SSIs are managed differently. Removal of instrumentation is required for effective treatment of delayed SSIs. This review article examines the current literature on the prevention and management of SSIs after pediatric spinal deformity surgery. |
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Keywords: | Spinal fusion Spinal surgery Scoliosis Spinal deformity Infection Complications Surgical site infection Spinal infection Pediatric Risk factors Prevention Instrumentation Infected spinal instrumentation Implant removal |
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