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 underwentmultilevel 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.
RCT Entities:
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.
Authors: David K Warren; Katelin B Nickel; Jennifer H Han; Pam Tolomeo; Christopher J Hostler; Katherine Foy; Ian R Banks; Victoria J Fraser; Margaret A Olsen Journal: Infect Control Hosp Epidemiol Date: 2020-05-05 Impact factor: 3.254
Authors: José Manuel Orenday-Barraza; María José Cavagnaro; Mauricio J Avila; Isabel Martha Strouse; Dara S Farhadi; Aaron Dowell; Naushaba Khan; Pedro Aguilar-Salinas; Robert Ravinsky; Ali A Baaj Journal: Eur Spine J Date: 2022-07-04 Impact factor: 2.721
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Authors: Shearwood McClelland; Richelle C Takemoto; Baron S Lonner; Tate M Andres; Justin J Park; Pedro A Ricart-Hoffiz; John A Bendo; Jeffrey A Goldstein; Jeffrey M Spivak; Thomas J Errico Journal: Int J Spine Surg Date: 2016-04-21
Authors: Kivanc Atesok; Efstathios Papavassiliou; Michael J Heffernan; Danny Tunmire; Irina Sitnikov; Nobuhiro Tanaka; Sakthivel Rajaram; Jason Pittman; Ziya L Gokaslan; Alexander Vaccaro; Steven Theiss Journal: Global Spine J Date: 2019-01-03