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• W4254993914 abstract "To describe the characteristics and evolution of deep surgical site infection following thoracolumbar instrumented spinal surgery (DSITIS) in our centre over a period of ten years. Descriptive retrospective study. Patient data (epidemiological/health status), surgical data, infection characteristics/presentation, isolated microorganisms, required surgical debridements, implant removal and major complications linked to infection were evaluated. We included 110 patients (80 females). Median follow-up after infection diagnosis was 3.6 years. Adolescent idiopathic scoliosis, adult deformity and degenerative lumbar stenosis were the most frequent aetiologies. Sixty-two percent of the patients had at least one clinical feature that made them prone to infection. Infection presentation was early (0–3 months from first surgery) in 60.4% of the cases, delayed (3–24 months) in 11.7%, and late (more than 24 months) in 27%. All patients were treated by surgical debridement. Twenty-five percent needed more than one surgical debridement. Implants were removed in 46% of the patients (71% in the first surgical debridement). The most frequent isolated microorganisms were coagulase-negative Staphylococcus, Propionibacterium acnes and Enterococcus. Major complications appeared in 15% of the patients, and 88% of them required major surgeries. Late DSITIS is more frequent than previously reported. Skin microorganisms predominate among the DSITIS culprits. DSIITS produce a high rate of major complications that usually require major surgery for treatment. Describir las características y la evolución de la infección profunda en cirugía instrumentada de raquis toracolumbar (IPCITL) en nuestro centro en un periodo de 10 años. Estudio descriptivo retrospectivo. Se analizan datos del paciente (epidemiológicos/salud), datos operatorios, presentación de la infección, gérmenes cultivados, limpiezas quirúrgicas requeridas, extracción de los implantes y complicaciones significativas derivadas de la infección. Se revisan 110 pacientes (80 mujeres). El seguimiento medio tras el diagnóstico de infección fue de 3,6 años. Etiologías más frecuentes: escoliosis idiopática del adolescente, deformidad del adulto y estenosis lumbar degenerativa. El 62% de pacientes presentaban algún dato clínico que les hacía proclives a la infección. La aparición de la infección fue precoz (0-3 meses de la cirugía primaria) en el 60,4% de los casos, retardada (3-24 meses) en el 11,7% y tardía (más de 24 meses) en el 27%. Todos los pacientes fueron tratados mediante limpieza quirúrgica. El 25% necesitaron más de una limpieza. Se extrajeron los implantes en el 46% de los pacientes (en el 71% de ellos en la primera limpieza). Los gérmenes aislados con mayor frecuencia fueron Staphylococcus coagulasa-negativo, Propionibacterium acnes y Enterococcus. Hubo complicaciones significativas derivadas de la IPCITL en el 15% de casos. El 88% de ellas precisaron cirugías complejas para su tratamiento. Las IPCITL tardías son más frecuentes de lo esperado según la literatura. En IPCITL globalmente predominan gérmenes cutáneos. Las IPCITL provocan una alta tasa de complicaciones, que habitualmente requieren tratamiento mediante cirugías complejas." @default.
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• W4254993914 date "2019-07-01" @default.
• W4254993914 modified "2023-09-27" @default.
• W4254993914 title "Deep surgical site infection following thoracolumbar instrumented spinal surgery. Ten years of experience" @default.
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• W4254993914 doi "https://doi.org/10.1016/j.recote.2019.05.002" @default.
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