000			04174nam a22006497a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a0148-7043
024			_a00000637-202405000-00015 [pii]
040			_aOvid MEDLINE(R)
099			_a38685496
245			_aPositive Bacterial Cultures on Spinal Wound Closure Do Not Predict Postoperative Outcomes.
251			_aAnnals of Plastic Surgery. 92(5):569-574, 2024 May 01.
252			_aAnn Plast Surg. 92(5):569-574, 2024 May 01.
253			_aAnnals of plastic surgery
260			_c2024
260			_fFY2024
260			_p2024 May 01
265			_sppublish
265			_tMEDLINE
266			_d2024-08-07
266			_z2024/04/30 00:16
501			_aAvailable online from MWHC library: 2001 - present, Available in print through MWHC library: 1999 - 2006
520			_aBACKGROUND: 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.
520			_aCONCLUSIONS: 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.
520			_aMETHODS: 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.
520			_aRESULTS: 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).
546			_aEnglish
650			_a*Surgical Wound Infection
650			_aAdult
650			_aAged
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aPlastic Surgery Procedures/ae [Adverse Effects]
650			_aPlastic Surgery Procedures/mt [Methods]
650			_aPostoperative Complications/ep [Epidemiology]
650			_aPostoperative Complications/mi [Microbiology]
650			_aPredictive Value of Tests
650			_aRetrospective Studies
650			_aSurgical Wound Infection/ep [Epidemiology]
650			_aSurgical Wound Infection/et [Etiology]
650			_aSurgical Wound Infection/mi [Microbiology]
650			_aTreatment Outcome
650			_aWound Closure Techniques
650			_aWound Healing
650			_zAutomated
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aSurgery/Plastic Surgery
657			_aJournal Article
700			_aFan, Kenneth L _bMWHC
700			_aTefera, Eshetu A _bMHRI
790			_aVanDolah HB, Li KR, Kim KG, Berger LE, Tefera EA, Acuna KA, Attinger CE, Fan KL, Evans KK
856			_uhttps://dx.doi.org/10.1097/SAP.0000000000003883 _zhttps://dx.doi.org/10.1097/SAP.0000000000003883
942			_cART _dArticle
999			_c14614 _d14614