Krishna V Suresh1, Majd Marrache1, Jaime Gomez2, Ying Li3, Paul D Sponseller4. 1. Department of Orthopaedic Surgery, Johns Hopkins University Hospital, 601 North Caroline Street, JHOC 5230, Baltimore, MD, 21287, USA. 2. Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA. 3. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA. 4. Department of Orthopaedic Surgery, Johns Hopkins University Hospital, 601 North Caroline Street, JHOC 5230, Baltimore, MD, 21287, USA. psponse@jhmi.edu.
Abstract
PURPOSE: The purpose is to compare the rate of recurrent deep wound infection in patients who retained MCGRs versus those who underwent implant removal and exchange following index deep wound infection. METHODS: Using a multicenter registry, we identified patients with EOS who underwent surgical correction with MCGR. We defined deep SSI as any infection that required subsequent I&D and antibiotic therapy. Recurrent infection was defined as any additional deep SSI following treatment of index deep infection. We considered MCGR to be salvaged if implant exchange or removal was not performed for at least 1 year following date of infection. Bivariate statistical analyses were performed. RESULTS: 992 EOS patients were identified, of whom 33 (3.3%) developed deep SSI. The mean time between initial surgery and first deep SSI was 13.1 months (Interquartile range [IQR]: 1 to 25 months. Infection rates by EOS diagnosis were as follows: 13/354 patients (3.6%) had neuromuscular scoliosis (NMS), 9/225 (4.0%) syndromic, 6/248 (2.4%) idiopathic, 3/135 congenital (2.2%), and 2/30 (6.6%) unknown etiology. MCGR was salvaged in 69% of NMS patients, 77% of syndromic patients, 100% of congenital patients, and 83% of idiopathic patients (83%). There were only four recurrent infections (2/13 NMS, 2/9 syndromic) and no differences in rates of recurrent infection between salvaged or replaced/exchanged MCGR. (p = 0.97). CONCLUSION: Deep wound infection occurred in 3% of MCGR patients at a mean of 13.1 months. There were no significant differences in rates of recurrent infection between salvaged implants and those removed or exchanged.
PURPOSE: The purpose is to compare the rate of recurrent deep wound infection in patients who retained MCGRs versus those who underwent implant removal and exchange following index deep wound infection. METHODS: Using a multicenter registry, we identified patients with EOS who underwent surgical correction with MCGR. We defined deep SSI as any infection that required subsequent I&D and antibiotic therapy. Recurrent infection was defined as any additional deep SSI following treatment of index deep infection. We considered MCGR to be salvaged if implant exchange or removal was not performed for at least 1 year following date of infection. Bivariate statistical analyses were performed. RESULTS: 992 EOS patients were identified, of whom 33 (3.3%) developed deep SSI. The mean time between initial surgery and first deep SSI was 13.1 months (Interquartile range [IQR]: 1 to 25 months. Infection rates by EOS diagnosis were as follows: 13/354 patients (3.6%) had neuromuscular scoliosis (NMS), 9/225 (4.0%) syndromic, 6/248 (2.4%) idiopathic, 3/135 congenital (2.2%), and 2/30 (6.6%) unknown etiology. MCGR was salvaged in 69% of NMS patients, 77% of syndromic patients, 100% of congenital patients, and 83% of idiopathic patients (83%). There were only four recurrent infections (2/13 NMS, 2/9 syndromic) and no differences in rates of recurrent infection between salvaged or replaced/exchanged MCGR. (p = 0.97). CONCLUSION: Deep wound infection occurred in 3% of MCGR patients at a mean of 13.1 months. There were no significant differences in rates of recurrent infection between salvaged implants and those removed or exchanged.
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