The use of antibiotics for wound prophylaxis in spinal surgery.

The principle of spinal surgery prophylaxis is to prevent naturally occurring organisms from infecting a sterile site. Avoiding infection is the most important concern in decreasing morbidity in the immediate perioperative period. Prophylactic cephalosporin is mandatory. Suction drains should be used until output is minimal. This lessons the chance of hematoma formation. Hematomas are excellent culture media and may result in seromas. Aspiration of seromas that are painful can lead to another source of possible infection. The efficacy of topical irrigants in preventing infections during lumbar spine surgery remains to be answered.