Clinical Analysis Of Surgical Site Infection After Lumbar Spine Fixation

BackgrandSurgical site infection(SSI)is an important part of the hospital acquired sexual infection.its classification includes superficial infection of incision,deep infection of incision,internal viscera and cavity infection.The anatomy of the lumbar spine from outside to inside is composed of the skin,fascia,muscles and vertebral vertebrae,so that SSI in lumbar spinal surgery is mainly caused by superficial and deep infection.Surgical site infection is one of the common complications after lumbar spine surgery.The risk factors that lead to it can be divided into preoperative patients' risk factors,surgical risk factors and postoperative risk factors.The related risk factors of preoperative patients mainly involved the general situation of the patients and the condition of the body,including diabetes,smoking,obesity,preoperative use of hormones and clear independent risk factors.Factors related to the operation environment,including the type of surgery,anesthesia,surgical equipment,operation time,intraoperative bleeding and blood transfusion and number of person in operation room,and postoperative risk factors is include hospitalization time,drainage tube retention time,etc.The diagnose of shallow incision infection and deep wound infection after Lumbar spinal internal fixation,is based on clinical manifestations,laboratory,imaging examination identification of early infection has reference value.But there is no relevant research concentrate on the difference between deep or shallow incision infection?At present,the research shows that shallow incision infection after lumbar spinal internal fixation surgery should be line broad spectrum antibiotic treatment as soon as possible,and actively complete the fluid dispensing clear pathogenic bacteria species and drug susceptibility test,check regularly laboratory index,according to the clinical manifestations,inflammation and imaging examination to decide whether to do surgery,and deep infection to surgical debridement therapy as soon as possible,but whether to keep internal fixation is controversial,the existence of the internal fixation can cause pathogenic bacteria remove impurities,and need surgery for many times.Therefore,through clinical manifestations,laboratory indicators,imaging examinations,effective identification of deep and superficial infection,and provide reference and guidance for postoperative infection treatment.Objective.By reviewing the relevant data of lumbar internal fixation patients,the risk factors of surgical site infection were discussed.According to the clinical manifestation,laboratory examination and imaging data,the deep and shallow layer infection were identified,providing reference for the treatment of postoperative infection in lumbar spine by choosing the treatment modality and effect of different infection.Method.Age,gender,diagnosis,diabetes history,operation time,surgical segment of 546 cases who underwent lumbar spinal internal fixation operation between April 2015 and December 2016 was collected to analysis the risk factors of postoperative infection,through comparing the infection time,clinical manifestation,laboratory examination,secretion culture,treatment method and follow-up of 30 patients who suffered postoperative infection,curative effect after postoperative infection was observed.ResultsIn 546 cases who underwent lumbar spine fixation,postoperative infection were performed in 5.49%.Diabetes(P = 0.004),gender(P = 0.024),and surgery time>3h(P=0.04)was the risk factors related to infection.Among the 30 patients in postoperative infection,28 cases were infected among 30 days,the average time of the postoperative infection was 10.85 ± 5.48 day,and two delayed infection was identified in 50d and 60d.All infectors were under secretion cultivation,and 19 cases got result.Staphylococcus aureus was 26.31%,52.63%was epidermal staphylococcus epidermis.when infection was confirmed,the antibiotics were used.But 70%of infectors(21/30)were needed debridement.An average follow-up was 10 months(8 to 15 months),and a case which got reinfection was suffered surgical treatment again.ConclusionOperation time>3h,diabetes,male was risk factor for postoperative infection.For superficial infection,the time of antibiotic use should be prolonged,and surgical treatment should be decided after the comprehensive evaluation.For deep infection patient,debridement was needed as soon as possible.