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PMID- 28394747
DA  - 20170410
DCOM- 20170417
LR  - 20170417
IS  - 1557-8674 (Electronic)
IS  - 1096-2964 (Linking)
VI  - 18
IP  - 3
DP  - 2017 Apr
TI  - Risk and Protective Factors Associated with Surgical Infections among Spine
PG  - 234-249
LID - 10.1089/sur.2016.183 [doi]
AB  - BACKGROUND: The purpose of the study was to identify patient-specific and
      procedure-specific risk and protective factors associated with post-operative
      surgical site infections (SSIs) among surgical spine patients. METHODS: CINAHL,
      PubMed, Ovid, Medline, and EBSCO databases were searched for articles within the 
      past 10 years (January 2003-March 2015). The keywords and combinations used in
      the search included: Spine surgery, post-operative infection, risk factors,
      orthopedic infections. The search resulted in 842 articles of which 29 met
      inclusion criteria. This systematic review adheres to preferred reporting items
      for systematic reviews and meta-analyses guidelines. RESULTS: Evidence about
      patient-specific and procedure-specific factors associated with increased risk of
      post-operative SSIs among patients undergoing orthopedic spinal surgery is
      inconclusive. Gender (male), age, body mass index, cigarette smoking, diabetes
      mellitus, a history of infection and alcohol abuse were identified as common
      patient-specific risk factors. Blood transfusion, implantation, and steroid use
      were found to increase SSIs in certain studies and associated with no significant
      difference in other studies. Protective factors include the implementation of
      pre-operative elements to reduce infection; protocols addressing patient-related 
      factors (smoking, weight, glucose) and operation-related factors (antibiotic
      prophylaxis, prosthetics, length of operation, and pre-operative cultures);
      incision drains placed intra-operatively; anterior approach; laminar-flow
      operating theater, and skin antisepsis using chlorhexidine. CONCLUSIONS:
      Interventions focusing on minimizing patient-specific risk factors and
      operation-specific risk factors and optimizing patient-specific protective
      factors and operation-specific protective factors are most effective in
      minimizing the likelihood of a post-operative infection among patients undergoing
      orthopedic spinal surgical procedures. The studies reviewed provide conflicting
      evidence relative to risk and protective factors.
FAU - Blood, Alyssa G
AU  - Blood AG
AD  - 1 Department of Orthopedics, University of Colorado-Denver School of Medicine ,
      Aurora, Colorado.
FAU - Sandoval, Melanie F
AU  - Sandoval MF
AD  - 1 Department of Orthopedics, University of Colorado-Denver School of Medicine ,
      Aurora, Colorado.
FAU - Burger, Evalina
AU  - Burger E
AD  - 1 Department of Orthopedics, University of Colorado-Denver School of Medicine ,
      Aurora, Colorado.
FAU - Halverson-Carpenter, Katherine
AU  - Halverson-Carpenter K
AD  - 2 University of Colorado Hospital , Anschutz Medical Campus, Aurora, Colorado.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170217
PL  - United States
TA  - Surg Infect (Larchmt)
JT  - Surgical infections
JID - 9815642
SB  - IM
MH  - Humans
MH  - Protective Factors
MH  - Risk Factors
MH  - Spinal Diseases/*surgery
MH  - *Spinal Injuries
MH  - Surgical Wound Infection/*epidemiology
OT  - *orthopedic spinal surgery
OT  - *post-operative risk factors
OT  - *post-operative spinal infection
OT  - *surgical site infection
EDAT- 2017/04/11 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/04/11 06:00
AID - 10.1089/sur.2016.183 [doi]
PST - ppublish
SO  - Surg Infect (Larchmt). 2017 Apr;18(3):234-249. doi: 10.1089/sur.2016.183. Epub
      2017 Feb 17.

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