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Rate of surgical site infections higher during the summer months
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Spine surgery in the summer may pose a higher risk of surgical site infections for patients, according to the results of a recently published study.
The relationship between surgical site infections (SSI) and the time of year is not understood, but previous studies have shown procedures in the summer tend to have a higher rate of infection. Investigators researched 6 years of prospective surveillance data (Jan. 1, 2007, to Dec. 31, 2012) from all laminectomies and spinal fusions from 20 hospitals in the Duke Infection Control Outreach Network.
The researchers identified 642 SSIs following 57,559 neurosurgical procedures: 215 infections after 24,466 laminectomies and 427 infections after 33,093 spinal fusions. The most common infection causes were Staphylococcus aureus (380 infections; 59%), coagulase-negative staphylococci (90 infections; 14%), and Escherichia coli (41 infections; 6.4%), according to the study results.
Despite the definition of summer (June through September or July through September), the 4-month period had higher rates of infection when compared to the remainder of the year.
The SSI resulting from gram-positive organisms, such as S. aureus and methicillin-sensitive S. aureus, had the highest rates during the summer, researchers found.
Researchers concluded it is unknown why gram-positive organisms cause higher SSIs during the summer months, but season-specific interventions to reduce the risk of gram-positive SSIs may be of value. – by Robert Linnehan
Disclosure: Durkin reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
Back to TopPeter Lewkonla, MD
Surgical site infection continues to be one of the more feared complications in spine surgery, both because of its frequency, as well as its potential consequences. Many of the risk factors for infection are outside of the surgeon’s control, such as obesity, pathology, and surgical approach, but there are some ways that infection rates can be modified.
In this study, the authors have reviewed a large consecutive cohort of patients at different times of the year in a non-teaching environment to specifically isolate the “summer” effect on infections from the impact of including trainees in the surgical procedure.
The persistent increase in infection rate strongly argues for some effect of the system during this time of year on infection risk. Although it is not clear what effect this might be, the work suggests we may be able to search for a modifiable factor to reduce the complication profile for patients treated over the summer months.
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