Impact of Plastic Surgery and an Enhanced Prophylaxis Protocol on Cervical Spine Surgery Infection
Background: Reduction of surgical site infections (SSIs) is important in improving cervical spine surgery outcomes. Plastic surgery involvement and an enhanced modified prophylaxis protocol may reduce infection rates. Methods: A total of 962 cervical spine operations were conducted by a single surge...
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| Veröffentlicht in: | Canadian journal of plastic surgery 2024-08, Vol.32 (3), p.445-451 |
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| container_title | Canadian journal of plastic surgery |
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| creator | Choudhri, Tanvir F. Li, Adam Y. Ali, Muhammad Spiera, Zachary Marayati, Naoum Fares Schupper, Alexander J. Durbin, John Asghar, Nek Dreher, Nickolas Hannah, Theodore Sayegh, Farah Bellaire, Christopher Harmaty, Marco A. Torina, Philip Ting, Jess Taub, Peter J. |
| description | Background: Reduction of surgical site infections (SSIs) is important in improving cervical spine surgery outcomes. Plastic surgery involvement and an enhanced modified prophylaxis protocol may reduce infection rates. Methods: A total of 962 cervical spine operations were conducted by a single surgeon (TFC). An enhanced modified prophylaxis protocol and plastic surgery were used in some operations. Differences in infection rates, surgical approach, previous operations, prophylaxis use, and plastic surgery involvement were compared using Fisher’s exact tests and multivariate linear regression. Results: Four patients (0.42%) experienced SSIs. All 4 infections involved the standard protocol, posterior approach, and did not involve plastic surgery. The infection rate was lower in the enhanced protocol group when compared to the standard protocol (β −0.78, 95% CI −1.23 to −0.33, P = .0008). The enhanced protocol group had an increased percentage of operations with plastic surgery (β 0.19, 95% CI 0.10 to 0.28, P |
| doi_str_mv | 10.1177/22925503221120542 |
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Plastic surgery involvement and an enhanced modified prophylaxis protocol may reduce infection rates. Methods: A total of 962 cervical spine operations were conducted by a single surgeon (TFC). An enhanced modified prophylaxis protocol and plastic surgery were used in some operations. Differences in infection rates, surgical approach, previous operations, prophylaxis use, and plastic surgery involvement were compared using Fisher’s exact tests and multivariate linear regression. Results: Four patients (0.42%) experienced SSIs. All 4 infections involved the standard protocol, posterior approach, and did not involve plastic surgery. The infection rate was lower in the enhanced protocol group when compared to the standard protocol (β −0.78, 95% CI −1.23 to −0.33, P = .0008). The enhanced protocol group had an increased percentage of operations with plastic surgery (β 0.19, 95% CI 0.10 to 0.28, P < .0001). The infection rate among the plastics group was 0.00% compared to 0.60% for the non-plastics group (P = .32). The plastics group had a lower rate of anterior approach when compared to the non-plastics group (β −0.20, 95% CI −0.24 to −0.15, P = .049). Among the posterior approach group, procedures with plastic surgery had an infection rate of 0.00% compared to 2.53% without plastic surgery (P = .13). Conclusion: The enhanced protocol was associated with a lower SSI rate and increased plastic surgery involvement. Posterior approaches were associated with increased infection rates and the likelihood of utilizing plastic surgery. Both the enhanced protocol and plastic surgery may decrease infection.</description><identifier>ISSN: 2292-5503</identifier><identifier>EISSN: 2292-5511</identifier><identifier>DOI: 10.1177/22925503221120542</identifier><identifier>PMID: 39104945</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Back surgery ; Disease prevention ; Infections ; Plastic surgery</subject><ispartof>Canadian journal of plastic surgery, 2024-08, Vol.32 (3), p.445-451</ispartof><rights>2022 The Author(s)</rights><rights>2022 The Author(s).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c250t-7d6b2736a5955ebf19c66e807e9d2937d2e996a2cc20b94887deaae8270b54c53</cites><orcidid>0000-0001-6527-9725 ; 0000-0001-7654-1469 ; 0000-0002-0229-8897</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/22925503221120542$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/22925503221120542$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39104945$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Choudhri, Tanvir F.</creatorcontrib><creatorcontrib>Li, Adam Y.</creatorcontrib><creatorcontrib>Ali, Muhammad</creatorcontrib><creatorcontrib>Spiera, Zachary</creatorcontrib><creatorcontrib>Marayati, Naoum Fares</creatorcontrib><creatorcontrib>Schupper, Alexander J.</creatorcontrib><creatorcontrib>Durbin, John</creatorcontrib><creatorcontrib>Asghar, Nek</creatorcontrib><creatorcontrib>Dreher, Nickolas</creatorcontrib><creatorcontrib>Hannah, Theodore</creatorcontrib><creatorcontrib>Sayegh, Farah</creatorcontrib><creatorcontrib>Bellaire, Christopher</creatorcontrib><creatorcontrib>Harmaty, Marco A.</creatorcontrib><creatorcontrib>Torina, Philip</creatorcontrib><creatorcontrib>Ting, Jess</creatorcontrib><creatorcontrib>Taub, Peter J.</creatorcontrib><title>Impact of Plastic Surgery and an Enhanced Prophylaxis Protocol on Cervical Spine Surgery Infection</title><title>Canadian journal of plastic surgery</title><addtitle>Plast Surg (Oakv)</addtitle><description>Background: Reduction of surgical site infections (SSIs) is important in improving cervical spine surgery outcomes. Plastic surgery involvement and an enhanced modified prophylaxis protocol may reduce infection rates. Methods: A total of 962 cervical spine operations were conducted by a single surgeon (TFC). An enhanced modified prophylaxis protocol and plastic surgery were used in some operations. Differences in infection rates, surgical approach, previous operations, prophylaxis use, and plastic surgery involvement were compared using Fisher’s exact tests and multivariate linear regression. Results: Four patients (0.42%) experienced SSIs. All 4 infections involved the standard protocol, posterior approach, and did not involve plastic surgery. The infection rate was lower in the enhanced protocol group when compared to the standard protocol (β −0.78, 95% CI −1.23 to −0.33, P = .0008). The enhanced protocol group had an increased percentage of operations with plastic surgery (β 0.19, 95% CI 0.10 to 0.28, P < .0001). The infection rate among the plastics group was 0.00% compared to 0.60% for the non-plastics group (P = .32). The plastics group had a lower rate of anterior approach when compared to the non-plastics group (β −0.20, 95% CI −0.24 to −0.15, P = .049). Among the posterior approach group, procedures with plastic surgery had an infection rate of 0.00% compared to 2.53% without plastic surgery (P = .13). Conclusion: The enhanced protocol was associated with a lower SSI rate and increased plastic surgery involvement. Posterior approaches were associated with increased infection rates and the likelihood of utilizing plastic surgery. Both the enhanced protocol and plastic surgery may decrease infection.</description><subject>Back surgery</subject><subject>Disease prevention</subject><subject>Infections</subject><subject>Plastic surgery</subject><issn>2292-5503</issn><issn>2292-5511</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kU1Lw0AQhhdRbKn9AV5kwYuX1v3IZrNHKVULBQvVc9hsJm1Kuht3E7H_3pTWCoqHYYbhed8ZZhC6pmRMqZT3jCkmBOGMUcqIiNgZ6u97IyEoPT_VhPfQMIQNIYRGgsdRcol6XFESqUj0UTbb1to02BV4UenQlAYvW78Cv8Pa5l3gqV1rayDHC-_q9a7Sn2XY140zrsLO4gn4j9LoCi_r0sJJPrMFmKZ09gpdFLoKMDzmAXp7nL5Onkfzl6fZ5GE-MkyQZiTzOGOSx1ooISArqDJxDAmRoHKmuMwZKBVrZgwjmYqSROagNSRMkkxERvABujv41t69txCadFsGA1WlLbg2pJwkSlAeE9aht7_QjWu97bbbU1ISRjnvKHqgjHcheCjS2pdb7XcpJen-B-mfH3Sam6Nzm20hPym-L94B4wMQ9Ap-xv7v-AW-8ozT</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Choudhri, Tanvir F.</creator><creator>Li, Adam Y.</creator><creator>Ali, Muhammad</creator><creator>Spiera, Zachary</creator><creator>Marayati, Naoum Fares</creator><creator>Schupper, Alexander J.</creator><creator>Durbin, John</creator><creator>Asghar, Nek</creator><creator>Dreher, Nickolas</creator><creator>Hannah, Theodore</creator><creator>Sayegh, Farah</creator><creator>Bellaire, Christopher</creator><creator>Harmaty, Marco A.</creator><creator>Torina, Philip</creator><creator>Ting, Jess</creator><creator>Taub, Peter J.</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6527-9725</orcidid><orcidid>https://orcid.org/0000-0001-7654-1469</orcidid><orcidid>https://orcid.org/0000-0002-0229-8897</orcidid></search><sort><creationdate>20240801</creationdate><title>Impact of Plastic Surgery and an Enhanced Prophylaxis Protocol on Cervical Spine Surgery Infection</title><author>Choudhri, Tanvir F. ; Li, Adam Y. ; Ali, Muhammad ; Spiera, Zachary ; Marayati, Naoum Fares ; Schupper, Alexander J. ; Durbin, John ; Asghar, Nek ; Dreher, Nickolas ; Hannah, Theodore ; Sayegh, Farah ; Bellaire, Christopher ; Harmaty, Marco A. ; Torina, Philip ; Ting, Jess ; Taub, Peter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c250t-7d6b2736a5955ebf19c66e807e9d2937d2e996a2cc20b94887deaae8270b54c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Back surgery</topic><topic>Disease prevention</topic><topic>Infections</topic><topic>Plastic surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choudhri, Tanvir F.</creatorcontrib><creatorcontrib>Li, Adam Y.</creatorcontrib><creatorcontrib>Ali, Muhammad</creatorcontrib><creatorcontrib>Spiera, Zachary</creatorcontrib><creatorcontrib>Marayati, Naoum Fares</creatorcontrib><creatorcontrib>Schupper, Alexander J.</creatorcontrib><creatorcontrib>Durbin, John</creatorcontrib><creatorcontrib>Asghar, Nek</creatorcontrib><creatorcontrib>Dreher, Nickolas</creatorcontrib><creatorcontrib>Hannah, Theodore</creatorcontrib><creatorcontrib>Sayegh, Farah</creatorcontrib><creatorcontrib>Bellaire, Christopher</creatorcontrib><creatorcontrib>Harmaty, Marco A.</creatorcontrib><creatorcontrib>Torina, Philip</creatorcontrib><creatorcontrib>Ting, Jess</creatorcontrib><creatorcontrib>Taub, Peter J.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choudhri, Tanvir F.</au><au>Li, Adam Y.</au><au>Ali, Muhammad</au><au>Spiera, Zachary</au><au>Marayati, Naoum Fares</au><au>Schupper, Alexander J.</au><au>Durbin, John</au><au>Asghar, Nek</au><au>Dreher, Nickolas</au><au>Hannah, Theodore</au><au>Sayegh, Farah</au><au>Bellaire, Christopher</au><au>Harmaty, Marco A.</au><au>Torina, Philip</au><au>Ting, Jess</au><au>Taub, Peter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Plastic Surgery and an Enhanced Prophylaxis Protocol on Cervical Spine Surgery Infection</atitle><jtitle>Canadian journal of plastic surgery</jtitle><addtitle>Plast Surg (Oakv)</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>32</volume><issue>3</issue><spage>445</spage><epage>451</epage><pages>445-451</pages><issn>2292-5503</issn><eissn>2292-5511</eissn><abstract>Background: Reduction of surgical site infections (SSIs) is important in improving cervical spine surgery outcomes. Plastic surgery involvement and an enhanced modified prophylaxis protocol may reduce infection rates. Methods: A total of 962 cervical spine operations were conducted by a single surgeon (TFC). An enhanced modified prophylaxis protocol and plastic surgery were used in some operations. Differences in infection rates, surgical approach, previous operations, prophylaxis use, and plastic surgery involvement were compared using Fisher’s exact tests and multivariate linear regression. Results: Four patients (0.42%) experienced SSIs. All 4 infections involved the standard protocol, posterior approach, and did not involve plastic surgery. The infection rate was lower in the enhanced protocol group when compared to the standard protocol (β −0.78, 95% CI −1.23 to −0.33, P = .0008). The enhanced protocol group had an increased percentage of operations with plastic surgery (β 0.19, 95% CI 0.10 to 0.28, P < .0001). The infection rate among the plastics group was 0.00% compared to 0.60% for the non-plastics group (P = .32). The plastics group had a lower rate of anterior approach when compared to the non-plastics group (β −0.20, 95% CI −0.24 to −0.15, P = .049). Among the posterior approach group, procedures with plastic surgery had an infection rate of 0.00% compared to 2.53% without plastic surgery (P = .13). Conclusion: The enhanced protocol was associated with a lower SSI rate and increased plastic surgery involvement. Posterior approaches were associated with increased infection rates and the likelihood of utilizing plastic surgery. Both the enhanced protocol and plastic surgery may decrease infection.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>39104945</pmid><doi>10.1177/22925503221120542</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6527-9725</orcidid><orcidid>https://orcid.org/0000-0001-7654-1469</orcidid><orcidid>https://orcid.org/0000-0002-0229-8897</orcidid></addata></record> |
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| subjects | Back surgery Disease prevention Infections Plastic surgery |
| title | Impact of Plastic Surgery and an Enhanced Prophylaxis Protocol on Cervical Spine Surgery Infection |
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