척추고정술 후 발생한 창상감염의 임상적 분석

Abstract

Postoperative wound infection remains a troublesome and not uncommon complication after spinal instrumentation. This study, representing a surgeon’s 10-year experience with postoperative infection at one institution, was performed to evaluate the risk factors, diagnosis, clinical manifestations, effective managements, and prognostic factors among patients with postoperative wound infection after spinal instrumentation. Of 418 operative procedures, 14 cases (mean age, 57 years) of wound infection were identified, yielding and overall infection ratio of 3.35%. Eight among 14 cases had significant preoperative risk factors (diabetes mellitus, smoker, obesity, alcoholism). Wound discharge was the most common presenting problem, with 92.8% experiencing this symptom. The most common cultured organism was Staphylococcus aureus, which was found in the wounds of eight patients(57.1%). All patients could be discharged after infection control without sequelae. C-reactive protein (CRP) was more correlated with clinical outcomes than other laboratory findings. Although wound infection after spinal instrumentation is a potentially devastating problem, this study suggests that aggressive surgical management, including repeated debridement followed by delayed closures, can result in preservation of instrumentation for fusion and acceptable postoperative outcomes.