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SCIP-INF-2: Prophylactic antibiotic selection for surgical patients (added 2007) SCIP-INF-3: Prophylactic antibiotics discontinued within 24 h after surgery end time (48 h for cardiac patients) SCIP-INF-4: Cardiac surgery patients with controlled 6 A.M. postoperative serum glucose management (≤200 mg/dL) (added 2008)
Methods to decrease surgical site infections in spine surgery include the application of antiseptic skin preparation (a.g. Chlorhexidine gluconate in alcohol which is twice as effective as any other antiseptic for reducing the risk of infection [9]), judicious use of surgical drains, prophylactic antibiotics, and vancomycin. [10]
The World Health Organization (WHO) published the WHO Surgical Safety Checklist in 2008 in order to increase the safety of patients undergoing surgery. [1] The checklist serves to remind the surgical team of important items to be performed before and after the surgical procedure in order to reduce adverse events such as surgical site infections or retained instruments. [1]
Depending on the type of surgery and anticipated contamination associated with it, combinations of different agents or different routes of administration (e.g. intravenous and oral antibiotics) might be beneficial in reducing perioperative adverse events. [6] [7] For prophylaxis in surgery, only antibiotics with good tolerability should be used.
Analgesics, antibiotics and anesthetics are usually prescribed to relieve pain, inflammation and swelling. Patients should refrain from vigorous exercise for the first few days after surgery and exercise caution when gradually resuming their normal activities. [32] Showering should also be avoided during the first few days after surgery.
An extended course of antibiotics is required in PJIs, usually 6–12 weeks of antibiotic therapy. [ 2 ] [ 4 ] Intravenous antibiotics are initially used and then transitioned to oral antibiotics. A strategy of surgical debridement to decrease the bacterial load prior to starting systemic antibiotics is sometimes employed. [ 4 ]
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IAIs can be classified into uncomplicated and complicated infections. Uncomplicated infections often involved the infection of single organ and can be controlled by surgical removal of the source of infection, and antibiotics is not required after the surgery to control the infection.