Positive Bacterial Cultures on Spinal Wound Closure Do Not Predict Postoperative Outcomes. 

 -  2024 
<br/><br/>Available online from MWHC library: 2001 - present, Available in print through MWHC library: 1999 - 2006 
<br/><br/> BACKGROUND: Complex surgical back wounds represent significant morbidity in patients who have undergone spinal procedures requiring closure or revision by plastic surgeons. This study aimed to assess the utility of bacterial wound culture data for predicting surgical outcomes of wound management.  CONCLUSIONS: Positive wound cultures were not significantly associated with negative outcomes after complex closure or reconstruction of infected spinal surgical wounds. This finding emphasizes the importance of clinical judgment with a multidisciplinary approach to complex surgical back wounds over culture data for wound closure timing. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.  METHODS: This study is a single-institution retrospective review of consecutive patients who required plastic surgery intervention for wound infection following spinal procedures between the years 2010 and 2021 (n = 70). Statistical analysis was performed for demographics, comorbidities, perioperative laboratory studies, and treatment methods. The primary outcomes of interest were rate of postoperative complications after soft tissue reconstruction and reconstructive failure. The secondary outcome of interest was time to healing in number of days.  RESULTS: The overall complication rate after wound closure was 31.4%, with wound infection in 12.9%, seroma in 10%, dehiscence in 12.9%, and hematoma in 1.4%. Increasing number of debridements before wound closure increased the likelihood of a surgical complication of any kind (odds ratio [OR], 1.772; 95% confidence interval [CI], 1.045-3.002). Positive wound cultures before reconstruction were associated with development of seroma only (OR, 0.265; 95% CI, 0.078-0.893). Use of incisional vacuum-assisted closure devices significantly decreased the odds of postoperative wound dehiscence (OR, 0.179; 95% CI, 0.034-0.904) and increased odds of healing (hazard ratio, 3.638; 95% CI, 1.547-8.613). 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0148-7043 
<br/><br/><label>Standard No.: </label>00000637-202405000-00015 [pii] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Surgical Wound Infection<br/>Adult<br/>Aged<br/>Female<br/>Humans<br/>Male<br/>Middle Aged<br/>Plastic Surgery Procedures/ae [Adverse Effects]<br/>Plastic Surgery Procedures/mt [Methods]<br/>Postoperative Complications/ep [Epidemiology]<br/>Postoperative Complications/mi [Microbiology]<br/>Predictive Value of Tests<br/>Retrospective Studies<br/>Surgical Wound Infection/ep [Epidemiology]<br/>Surgical Wound Infection/et [Etiology]<br/>Surgical Wound Infection/mi [Microbiology]<br/>Treatment Outcome<br/>Wound Closure Techniques<br/>Wound Healing--Automated
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute<br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Surgery/Plastic Surgery
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article