Alberto Ruffilli, Francesca Barile, Michele Fiore, Marco Manzetti, Giovanni Viroli, Antonio Mazzotti, Marco Govoni, Lucia De Franceschi, Dante Dallari, Cesare Faldini
{"title":"Allogenic bone grafts and postoperative surgical site infection: are positive intraoperative swab cultures predictive for a higher infectious risk?","authors":"Alberto Ruffilli, Francesca Barile, Michele Fiore, Marco Manzetti, Giovanni Viroli, Antonio Mazzotti, Marco Govoni, Lucia De Franceschi, Dante Dallari, Cesare Faldini","doi":"10.1007/s10561-022-10061-1","DOIUrl":null,"url":null,"abstract":"<p><p>In spine surgery, allogenic bone grafts are often required to ensure bone fusion, however, the main concern regarding their use is the infection risk: therefore, an intraoperative swab for culture test is performed. The cost-effectiveness of these swabs and their influence on the patients' postoperative course have often been questioned. This study aims at determining whether positive spine allograft culture results are predictive of an increased risk of surgical site infection and whether they influence the surgeon's choices in postoperative management. The records of 340 patients who received allogenic bone graft during spinal fusion surgery in our institution were reviewed, for a total of 677 allografts. Each graft was swabbed intraoperatively. All patients were followed clinically for postoperative complications. Infection was diagnosed based on clinical data, blood tests and radiographic images, all assessed by an infectious disease specialist. Only 4 of the 677 allografts used (0.6%) resulted positive at the intraoperative swab culture. Three cultures were positive for Staphylococcus epidermidis and one culture for S. warneri. No clinical infection occurred in any of these patients. Twenty-eight of the 340 patients (8.2%) developed an infection, but none of them had a positive intraoperative swab culture. The most common microbiologic pathogen isolated from this cohort was S. aureus. According to our series, intraoperative swab culture results were not predictive for higher risk of infection and did not affect the clinical behavior of the surgeons in postoperative management.</p>","PeriodicalId":9723,"journal":{"name":"Cell and Tissue Banking","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cell and Tissue Banking","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s10561-022-10061-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CELL BIOLOGY","Score":null,"Total":0}
引用次数: 2
Abstract
In spine surgery, allogenic bone grafts are often required to ensure bone fusion, however, the main concern regarding their use is the infection risk: therefore, an intraoperative swab for culture test is performed. The cost-effectiveness of these swabs and their influence on the patients' postoperative course have often been questioned. This study aims at determining whether positive spine allograft culture results are predictive of an increased risk of surgical site infection and whether they influence the surgeon's choices in postoperative management. The records of 340 patients who received allogenic bone graft during spinal fusion surgery in our institution were reviewed, for a total of 677 allografts. Each graft was swabbed intraoperatively. All patients were followed clinically for postoperative complications. Infection was diagnosed based on clinical data, blood tests and radiographic images, all assessed by an infectious disease specialist. Only 4 of the 677 allografts used (0.6%) resulted positive at the intraoperative swab culture. Three cultures were positive for Staphylococcus epidermidis and one culture for S. warneri. No clinical infection occurred in any of these patients. Twenty-eight of the 340 patients (8.2%) developed an infection, but none of them had a positive intraoperative swab culture. The most common microbiologic pathogen isolated from this cohort was S. aureus. According to our series, intraoperative swab culture results were not predictive for higher risk of infection and did not affect the clinical behavior of the surgeons in postoperative management.
期刊介绍:
Cell and Tissue Banking provides a forum for disseminating information to scientists and clinicians involved in the banking and transplantation of cells and tissues. Cell and Tissue Banking is an international, peer-reviewed journal that publishes original papers in the following areas:
basic research concerning general aspects of tissue banking such as quality assurance and control of banked cells/tissues, effects of preservation and sterilisation methods on cells/tissues, biotechnology, etc.; clinical applications of banked cells/tissues; standards of practice in procurement, processing, storage and distribution of cells/tissues; ethical issues; medico-legal issues.