Analysis of Risk Factors and Treatment of Surgical Site Infection after Spinal Instrumentation Surgery

Abstract：Objective The clinical data of postoperative infection of spinal internal fixation was analyzed by logistic regression analysis to determine the independent risk factors and to explore the prevention and treatment measures based on independent factors.Methods The cases of postoperative infection after spinal internal fixation operation from June 2006 to June 2015 at orthodontics of Affiliated Hospital of Guizhou Medical University were analyzed.There were 23 patients diagnosed as postoperative infection.The reasons of postoperative infection in each case were discussed.Ac-cording to the domestic and foreign literatures,infection related risk factors were selected as observation index and ca-ses were divided into infection group and non-infection group according to observation index.The number of cases for each group was counted.Logistic regression was used to analyze the correlation among selecting risk factors for infection after spine internal fixation.Statistical methods were used for Chi-square test,single factor analysis of Logistic regres-sion and multivariate Logistic regression analysis.To find out the high risk factors and independent risk factors and summarize the prevention and treatment measures of infection after spinal internal fixation.Results According to the statistical analysis,1042 cases of spinal internal fixation surgery in our department in the past nine years,the postoper-ative infection rate was 2.20％ (23/1042).We used for the chi-square test and single factor analysis of Logistic regres-sion to analyze the risk factors.Age,obesity,malnutrition,American society of anesthesiologists score (ASA score), surgical region,surgical approach,the application of steroids,the amount of blood loss and blood transfusion,postopera-tive cerebrospinal fluid leakage,the drainage tube placement time were inculded.The analysis showed that these factors were not correlated with spinal internal fixation infection.The independent risk factors of postoperative infection of spi-nal internal fixation analysed by multivariate logistic regression were diabetes,long-term smoking,prophylactic antibi-otics without standardized using,incontinence,operation segment of spine,operation time,spinal surgery trauma index. We analyzed the effect of infection factors and statistical independent risk factors for patients.The corresponding pre-ventive measures were summarized for independent risk factors.The treatment of infected patients were divided into two categories:conservative treatment and surgical treatment.Conclusion Patients with those seven independent risk factors of infection following spinal instrumentation surgery should be taken preventive measures.Patients with postop-erative infection should be immediately treated with corresponding measures.Patients who have been diagnosed postop-erative infection should be treated with comprehensive treatment by highly sensitive antibiotics,thorough debridement and drainage.