Surgical associated factors — preoperative radiation/postoperative blood transfusion , combined anterior/posterior approach , surgical invasiveness , or levels of instrumentation were associated with increased SSI .
There is mixed evidence of age , duration of surgery , surgical team , intraoperative blood loss , dural tear , and urinary tract infection/urinary catheter in association with SSI .
Conclusion : SSIs are associated with many risk factors that can be patient or surgically related .
Objective : To perform a review of SSI risk factors and more specifically , categorize them into patient and surgical factors .
Intraoperative Fraction of Inspired Oxygen Is a Modifiable Risk Factor for Surgical Site Infection after Spinal Surgery
Background : Surgical site infections ( SSI ) after spinal surgery increase morbidity , mortality , length of hospital stay , and costs . Most previously identified risk factors for these infections , such as severity of illness and procedure duration , are not amenable to intervention . This study sought to identify modifiable risk factors associated with SSI after spinal surgery . Methods : This is a case-control study including case identification and review of medical records . A total of 104 patients with SSI after spinal surgery were compared to 104 r and omly selected control patients without SSI after spinal surgery in a 926-bed tertiary care hospital in Baltimore , Maryl and , between April 1 , 2001 and December 31 , 2004 . Results : Multivariate analysis identified independent risk factors for SSI after spinal surgery including prolonged procedure duration ( odds ratio [ OR ] , 4.7 ; 95 % confidence interval [ 95 % CI ] , 1.6–14 ; P < 0.001 ) , American Society of Anesthesiologists score of 3 or greater ( OR , 9.7 ; 95 % CI , 3.7–25 ; P < 0.001 ) , lumbar-sacral operative level ( OR , 2.9 ; 95 % CI , 1.2–7.1 ; P = 0.02 ) , posterior approach ( OR , 3.5 ; 95 % CI , 1.2–9.7 ; P = 0.02 ) , instrumentation ( OR , 2.5 ; 95 % CI , 1.1–6.0 ; P = 0.03 ) , obesity ( OR , 4.0 ; 94 % CI , 1.6–10 ; P < 0.01 ) , razor shaving before surgery ( OR , 3.6 ; 95 % CI , 1.2–11 ; P = 0.02 ) , and intraoperative administered fraction of inspired oxygen of less than 50 % ( OR , 12 ; 94 % CI , 4.5–33 ; P < 0.001 ) . Conclusions : In addition to previously reported risk factors , this study identified intraoperative administered fraction of inspired oxygen of less than 50 % as an independent , modifiable risk factor for SSI after spinal surgery . Intraoperative administration of at least 50 % fraction of inspired oxygen should be tested prospect ively as an intervention to prevent SSI after spinal surgery
Surgical associated factors — preoperative radiation/postoperative blood transfusion , combined anterior/posterior approach , surgical invasiveness , or levels of instrumentation were associated with increased SSI .
There is mixed evidence of age , duration of surgery , surgical team , intraoperative blood loss , dural tear , and urinary tract infection/urinary catheter in association with SSI .
Conclusion : SSIs are associated with many risk factors that can be patient or surgically related .
Objective : To perform a review of SSI risk factors and more specifically , categorize them into patient and surgical factors .