Abstract
Aim:
Deep infection following paediatric spinal deformity surgery is a serious complication, which can also result in increased length of stay and significant cost implications. Our objective was to reduce deep infection rates following spinal deformity surgery.
Method:
All paediatric patients undergoing spinal deformity procedures between 2008 and 2010 (group 1) were prospectively followed up and deep infection rates recorded. In 2010, a review of infection rates necessitated a change in pre-operative, peri-operative, and post-operative practice. A scoliosis wound care pathway was implemented, which involved insertion of drains to protect wounds, strict dressing management performed by a Spinal Nurse Practitioner, and a telephone helpline for concerns about wound care and general peri-operative scoliosis care. The use of betadine wash and local antibiotic application intra-operatively were other measures instigated later in this period. All paediatric patients undergoing surgery between 2011 and 2012 (group 2) were then followed up and differences in infection rates between the two groups were analysed.
Results:
260 patients undergoing 275 procedures were included in this study. Numbers of operations increased from 38 in 2008 to 71 in 2012. There were 19 neuromuscular, 19 congenital, and 42 idiopathic cases in group 1 and 15, 35, and 84 in group 2. Deep infection rates reduced significantly from 15% to 0.75% (p<0.0001).
Discussion:
Deep infection rates following paediatric spinal deformity surgery can be significantly reduced by use of a team-based multi-modal approach. A robust scoliosis wound care pathway is essential to maintain high standards post-operatively.
Conflict Of Interest Statement: No conflict of interest.
