Is There an Association Between Preoperative PONV Prophylaxis With Dexamethasone and Incidence of Wound Revisions in the Surgical Treatment of Pediatric Secondary Scoliosis? A Retrospective Cross-Sectional Study in 162 Patients.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2026-10-09 DOI:10.1097/BSD.0000000000002186

Nima Taheri, Zhao Li, Zhen Wang, Konstantin Cloeren, Antonia Koch, Serafeim Tsitsilonis, Friederike Schömig, Michael Putzier, Matthias Pumberger, Paul Köhli

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引用次数: 0

Abstract

Background data: Pediatric patients undergoing surgery for secondary scoliosis are at special risk for surgical site infections (SSIs). The application of dexamethasone (Dexa) for perioperative prophylaxis of postoperative nausea and vomiting is an established method. Despite the benefits, there is still concern regarding an increased risk for SSI.

Objective: This study aimed to evaluate the association between perioperative Dexa administration for PONV prophylaxis and the occurrence of SSI requiring surgical revision in pediatric patients undergoing surgery for secondary scoliosis.

Study design: Single-center retrospective cohort study.

Methods: Patients younger than 18 years undergoing surgical treatment for secondary scoliosis between January 2017 and December 2021 were included. Demographic and surgical data were extracted from medical records and discharge summaries. SSI requiring surgical reintervention was the primary outcome. Statistical analysis was conducted using the Mann-Whitney U test, Fisher exact test, and Fisher-Freeman-Halton test, univariable and bivariable logistic regression.

Results: One hundred sixty-two patients were included (Dexa: n=30, control: n=132). There were no significant differences considering demographics (P>0.05). Patients receiving Dexa underwent undergoing revision surgery more often or had meningomyelocele (MMC). The overall incidence of infection was 11/162. Patients receiving Dexa showed a higher incidence of SSI requiring surgical reintervention (6/30 vs. 5/132, P=0.01) and were at higher Odds for SSI (OR: 5.25, 95% CI: 1.53-18.15, P=0.007), which remained significant after adjusting for confounders (MMC: OR: 3.97, 95% CI: 1.08-14.38, P=0.033; revision surgery: OR: 3.97, 95% CI: 1.08-14.38, P=0.033).

Conclusions: This study observed an association between the preoperative application of Dexa for PONV prophylaxis in secondary scoliosis surgery and an increased risk of SSI. Our results give reason for a more thoughtful application of Dexa-based PONV prophylaxes in the perioperative therapy of a population of high-risk children for SSI with secondary scoliosis.

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在小儿继发性脊柱侧凸手术治疗中，术前使用地塞米松预防PONV与伤口修复发生率之间是否存在关联？162例患者的回顾性横断面研究。

背景资料：接受手术治疗继发性脊柱侧凸的儿科患者手术部位感染（ssi）的风险特别高。地塞米松（Dexa）应用于围手术期预防术后恶心呕吐是一种既定的方法。尽管有好处，但仍有关于SSI风险增加的担忧。目的：本研究旨在评估小儿继发性脊柱侧凸手术患者围手术期给予Dexa预防PONV与需要手术翻修的SSI发生之间的关系。研究设计：单中心回顾性队列研究。方法：纳入2017年1月至2021年12月期间接受继发性脊柱侧凸手术治疗的18岁以下患者。从医疗记录和出院摘要中提取人口统计学和外科数据。SSI需要手术再干预是主要结局。统计分析采用Mann-Whitney U检验、Fisher精确检验、Fisher- freeman - halton检验、单变量和双变量logistic回归。结果：纳入162例患者（Dexa: n=30, control: n=132）。统计学差异无统计学意义（P < 0.05）。接受Dexa治疗的患者更常接受翻修手术或有脑膜脊髓膨出（MMC）。总感染率为11/162。接受Dexa治疗的患者SSI再次手术的发生率更高（6/30比5/132，P=0.01）， SSI的发生率更高（OR: 5.25, 95% CI: 1.53-18.15， P=0.007），在调整混杂因素后，这一差异仍然显著（MMC: OR: 3.97, 95% CI: 1.08-14.38， P=0.033；翻修手术：OR: 3.97, 95% CI: 1.08-14.38， P=0.033）。结论：本研究观察到在继发性脊柱侧凸手术中术前应用Dexa进行PONV预防与SSI风险增加之间的关联。我们的研究结果为在SSI伴继发性脊柱侧凸的高危儿童围手术期治疗中更周到地应用基于dexa的PONV预防提供了理由。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.