Article
Postoperative wound infections in a neurosurgical spectrum – identification of patients at high risk
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Authors
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Stephanie Schipmann
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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Christian Ewelt
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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Eric J. Suero Molina
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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Christian Ertmer
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster
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Mark Klingenhöfer
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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Lars Lemcke
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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Michael Schwake
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
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Walter Stummer
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster
| Published: | May 13, 2014 |
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Outline
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Objective: Postoperative wound infections in neurosurgical patients result additional morbidity. In order to reduce the incidence of wound infections the application of a single shot of antibiotics 30 minutes prior to surgery has been established during the last years. Our study aimed at analyzing possible risk factors for wound infections and in order to identify a patient collective at high risk for infectious complications.
Method: Patients undergoing neurosurgical procedures between January 2012 and May 2013, at the Department of Neurosurgery, University Hospital Münster, were assessed for this retrospective study. The complete medical records of each case were reviewed and all postoperative wound infections with the need of surgical intervention were recorded. Statistical analyses were performed for identifying the rate of wound infections and possible risk factors.
Results: A total of 47 cases of postoperative wound infections were identified among 2367 neurosurgical procedures and included in the study, with a resulting overall infection rate of 1.99%. Brain surgery had a slightly higher risk for wound infection with 33 cases among 1325 operations (2.49%) than spine surgery (14/ 661; 2.12%). The median for the period of the manifestation of wound infection was 30 days. Statistical analyses of patient data identified a patient collective at high risk for wound infection, comprising patients with the history of radiotherapy to the surgical field, patients under chemotherapy, patients who underwent >2 operations in the same region, and patients undergoing spine surgery with the need of spondylodesis. The most frequent microorganisms found were staphylococcus aureus (n= 10, 31.9%) and staphylococcus epidermidis (n= 5, 10.6%).
Conclusions: The present data indicate a low incidence of postoperative wound infection in our surgical spectrum using modern techniques and single shot antibiotics. However, wound infections remain an important problem in neurosurgery as they cause further complications, major costs and prolong hospital stay. Our study identified patients at high risk for wound infections. We suggest performing three-day postoperative antibiotic prophylaxis in these patient collectives. Further prospective studies are needed to evaluate the effectiveness of prolonged prophylactic antibiotic therapy.
