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 .
Infection Rate After Transoral Approach for the Upper Cervical Spine
Study Design . A retrospective review of prospect ively collected data bases of 139 consecutive patients who underwent transoral surgery for lesions of the upper cervical spine . Objective . To analyze the incidence and risk factors of local infection after  transoral surgery  for the craniocervical junction in a single institution and to compare the findings with the literature . Summary of Background Data . One of the primary risks associated with transoral approach for lesions in the upper cervical spine is postoperative surgical wound infection . Methods . From April 1994 to December 2012 , 139 consecutive transoral surgical procedures were performed at a single referral center . The mean age at presentation was 53.6 years ( range : 5–87 yr ) , and more than half of the patients were males ( 58.3 % ) . The majority of cases were experiencing rheumatic diseases ( 43.9 % ) , whereas tumor destruction was the indication for surgery in 23.7 % of the cases . A total of 23 % had fracture of the upper cervical spine and primary infection was found in 7 patients ( 5 % ) . The mean follow-up period was 4.5 years . Results . Infection of the pharyngeal wound occurred in 5 patients ( 3.6 % ) , solely in the rheumatic and tumor groups . The presentation was mostly in the first 4 months . A single patient with cage reconstruction after giant cell tumor C2 presented with a late infection 5 years postoperatively . Debridement and primary closure was possible in 2 patients , whereas flap coverage of the pharyngeal wall was necessary in 3 patients . The presence of implant did not have a statistically significant effect on the occurrence of infection . However , infection in the presence of titanium cage mostly necessitated flap coverage of the pharyngeal wall after removal of the cage . Conclusion . The transoral route has proved to be an invaluable method of approaching pathological lesions in the upper cervical spine . The infection rate in this work was 3.6 % . Patients with rheumatic diseases and patients presenting with tumors were more susceptible to postoperative surgical wound infection . Level of Evidence :
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 .