Tanvir F Choudhri, Adam Y Li, Muhammad Ali, Zachary Spiera, Naoum Fares Marayati, Alexander J Schupper, John Durbin, Nek Asghar, Nickolas Dreher, Theodore Hannah, Farah Sayegh, Christopher Bellaire, Marco A Harmaty, Philip Torina, Jess Ting, Peter J Taub
{"title":"整形手术对颈椎手术感染的影响及强化预防方案","authors":"Tanvir F Choudhri, Adam Y Li, Muhammad Ali, Zachary Spiera, Naoum Fares Marayati, Alexander J Schupper, John Durbin, Nek Asghar, Nickolas Dreher, Theodore Hannah, Farah Sayegh, Christopher Bellaire, Marco A Harmaty, Philip Torina, Jess Ting, Peter J Taub","doi":"10.1177/22925503221120542","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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, <i>P</i> = .0008). The enhanced protocol group had an increased percentage of operations with plastic surgery (β 0.19, 95% CI 0.10 to 0.28, <i>P</i> < .0001). The infection rate among the plastics group was 0.00% compared to 0.60% for the non-plastics group (<i>P</i> = .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, <i>P</i> = .049). Among the posterior approach group, procedures with plastic surgery had an infection rate of 0.00% compared to 2.53% without plastic surgery (<i>P</i> = .13). <b>Conclusion:</b> 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.</p>","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11298146/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of Plastic Surgery and an Enhanced Prophylaxis Protocol on Cervical Spine Surgery Infection.\",\"authors\":\"Tanvir F Choudhri, Adam Y Li, Muhammad Ali, Zachary Spiera, Naoum Fares Marayati, Alexander J Schupper, John Durbin, Nek Asghar, Nickolas Dreher, Theodore Hannah, Farah Sayegh, Christopher Bellaire, Marco A Harmaty, Philip Torina, Jess Ting, Peter J Taub\",\"doi\":\"10.1177/22925503221120542\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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, <i>P</i> = .0008). The enhanced protocol group had an increased percentage of operations with plastic surgery (β 0.19, 95% CI 0.10 to 0.28, <i>P</i> < .0001). The infection rate among the plastics group was 0.00% compared to 0.60% for the non-plastics group (<i>P</i> = .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, <i>P</i> = .049). Among the posterior approach group, procedures with plastic surgery had an infection rate of 0.00% compared to 2.53% without plastic surgery (<i>P</i> = .13). <b>Conclusion:</b> 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.</p>\",\"PeriodicalId\":20206,\"journal\":{\"name\":\"Plastic surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11298146/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Plastic surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/22925503221120542\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/9/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/22925503221120542","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/9/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
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 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.
期刊介绍:
Plastic Surgery (Chirurgie Plastique) is the official journal of the Canadian Society of Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery, Group for the Advancement of Microsurgery, and the Canadian Society for Surgery of the Hand. It serves as a major venue for Canadian research, society guidelines, and continuing medical education.