Appropriateness of Twenty-four-Hour Antibiotic Prophylaxis After Spinal Surgery in Which a Drain Is Utilized A Prospective Randomized Study

作者:Takemoto Richelle C*; Lonner Baron; Andres Tate; Park Justin; Ricart Hoffiz Pedro; Bendo John; Goldstein Jeffrey; Spivak Jeffrey; Errico Thomas
来源:Journal of Bone and Joint Surgery-American Volume, 2015, 97A(12): 979-986.
DOI:10.2106/JBJS.L.00782

摘要

Background: Wound drains that are left in place for a prolonged period of time have a higher rate of bacterial contamination. Following spinal surgery, a drain is often left in place for a longer period of time if it maintains a high output. Given the major consequences of an infection following spinal surgery and the lack of data with regard to the use of antibiotics and drains, we performed a study of patients with a drain following spinal surgery to compare infection rates between those who were treated with antibiotics for twenty-four hours and those who received antibiotics for the duration for which the drain was in place. Methods: We performed a prospective randomized trial of 314 patients who underwent multilevel thoracolumbar spinal surgery followed by use of a postoperative drain. The patients were randomized into two groups, one of which received perioperative antibiotics for twenty-four hours (twenty-four-hour group) and the other of which received antibiotics for the duration that the drain was in place (drain-duration group). Data collected included demographic characteristics, medical comorbidities, type of spinal surgery, and surgical site infection. Results: Twenty-one (12.4%) of the 170 patients in the twenty-four-hour group and nineteen (13.2%) of the 144 in the drain-duration group developed a surgical site infection (p = 0.48). There were no significant differences between the twenty-four-hour and drain-duration groups with respect to demographic characteristics (except for the American Society of Anesthesiologists [ASA] classification), operative time, type of surgery, drain output, or length of hospital stay. Conclusions: Continuing perioperative administration of antibiotics for the entire duration that a drain is in place after spinal surgery did not decrease the rate of surgical site infections.

  • 出版日期2015-6-17