Risk Factors for Wound Infection in Spinal Surgery: A Focus on Diabetes Mellitus
10.4184/jkss.2018.25.3.115
- Author:
Hun Kyu SHIN
1
;
Jong Kuen PARK
;
Eugene KIM
;
Jai Hyung PARK
;
Se Jin PARK
;
Sang Hoon HA
;
Hwa Jae JEONG
Author Information
1. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. kneedoc@naver.com
- Publication Type:Original Article
- From:Journal of Korean Society of Spine Surgery
2018;25(3):115-121
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES:To identify risk factors for infection after spinal surgery.SUMMARY OF LITERATURE REVIEW: Infection after spinal surgery is relatively uncommon. However, such infections cause serious consequences and increased costs and sequelae. Risk factors for infection after spinal surgery include a posterior approach, instrumentation, the use of an allogenic bone graft, transfusion, and a long operating time. Patient-related factors include diabetes and obesity.
MATERIALS AND METHODS:From January 2009 to December 2013, 350 patients who underwent surgery at our hospital due to spinal disease, including 10 patients with a postoperative spinal infection, were evaluated. We investigated patients' age, gender, morbidity due to diabetes mellitus, body mass index, level of surgery, approach, location, instrumentation, and operation type.
RESULTS:Ten of the 350 patients developed a spinal infection after surgery. The proportion of diabetic patients among the infected patients was higher than among the non-infected patients, although the difference was not statistically significant. Additionally, the proportion of diabetic patients with hemoglobin A1c levels greater than 7.0% was higher among the infected patients. Operating time, the surgical approach, drain tube insertion, transfusion, and the use of an allogenic bone graft were not significantly different between the infected and non-infected patient groups.
CONCLUSIONS:Uncontrolled diabetes is the most important risk factor for the development of spinal infection after surgery. Therefore, in order to prevent infection after surgery, blood glucose should be controlled before surgery.
