Risk Factors for Wound Infections after Deformity Correction Surgery in Neuromuscular Scoliosis.

Abstract:

OBJECTIVE:This study aims to elucidate surgical risk factors in neuromuscular scoliosis (NMS) with respect to wound site infection after spinal fusion. METHODS:A retrospective review was performed of all patients treated surgically for NMS between January 2008 and December 2016 (minimum 6 months' follow-up). A sub-cohort of 60 patients with minimum 2 years of follow-up data was also analyzed. RESULTS:In 102 patients (53 boys and 49 girls), the mean age at surgery was 14.0 years (SD ±2.7). Mean follow-up was 2.53 years (±1.66), and mean time to presentation of infection was 2.14 months (±4.95). The overall perioperative complication rate was 26.5%, with 14.7% of patients developing deep wound infection. Gram-negative bacteria were responsible for 60% of infections; 20% were Gram positive, and 20% involved both types. Pulmonary comorbidities (p = 0.007), pre- to postoperative increase in weight (p = 0.010), exaggerated lumbar lordosis at follow-up (p = 0.008), history of seizures (p = 0.046), previous myelomeningocele repair (p = 0.046), and previous operations (p = 0.013) were significant risk factors for infection. CONCLUSION:Our data suggest that in the pediatric population treated surgically for NMS, wound infection is strongly associated with postoperative increase in body weight, residual lumbar lordosis, pulmonary comorbidity, history of myelomeningocele repair, seizures, and previous operations.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Janjua MB,Toll B,Ghandi S,Sebert ME,Swift DM,Pahys JM,Samdani AF,Hwang SW

doi

10.1159/000496693

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

108-115

issue

2

eissn

1016-2291

issn

1423-0305

pii

000496693

journal_volume

54

pub_type

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