Early bedside wound irrigation can prevent surgical site infection following open posterior lumbar surgery, a preliminary two-center study

Background: Delayed diagnosis of surgical site infection (SSI) in lumbar surgery may eventually result in surgical failure. In this prospective two-centers study, we introduced a method to identify and control likely SSI following OPLS at early stages. Methods. Patients with likely SSI according to our criteria were enrolled. A bedside irrigation treatment with no need for anesthesia would then be placed. Clinical information including the pre-operative characteristics and post-operative outcomes were collected and fully analyzed. All patients were followed up for 1 year after their hospital discharge. Results. Among 672 patients who received OPLS, there are 72 patients (10.7%) diagnosed with likely SSI. Lumbar spinal stenosis (41 cases, 56.9%) accounts for the most common primary diagnosis. Only 14 of the 72 patients (19.4%) have a positive microbiological tests result. During the bedside irrigation, the level of inflammatory biomarkers demonstrated a rapid decrease. The irrigation lasted for an average time of 5.4 ± 1.2 days. The average time for antibiotics administration is 13.8 ± 4.3 days. The average length of hospital stay is 27.1 ± 5.6 days. The fusion rates at 6-months and 12-moths are 84.7% and 97.2% respectively. None patient had even a minimal disability at 1-year follow up according to the Oswestry Disability Index. Conclusions. Early identification and control of likely SSI following OPLS is valuable in clinical practice and the bedside irrigation system seems to be a safe and effective choice. Future large sample sized control studies are awaited to provide stronger evidence for its efficacy.