Evidence map›Paper›PMID 37967971›Full record

Observational studyCanadian journal of surgery. Journal canadien de chirurgie

Effectiveness of prophylactic intranasal photodynamic disinfection therapy and chlorhexidine gluconate body wipes for surgical site infection prophylaxis in adult spine surgery.

Eryck Moskven, Daniel Banaszek, Eric C Sayre, Aleksandra Gara, Elizabeth Bryce, Titus Wong, Tamir Ailon, Raphaële Charest-Morin, Nicolas Dea, Marcel F Dvorak and 4 more

Open access · diamondAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

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  6. Implementation ofJTCVS techniques · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Eryck MoskvenFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong) eryckmoskven@rcsi.ie.
Daniel BanaszekFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Eric C SayreFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Aleksandra GaraFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Elizabeth BryceFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Titus WongFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Tamir AilonFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Raphaële Charest-MorinFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Nicolas DeaFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Marcel F DvorakFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Charles G FisherFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Brian K KwonFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Scott PaquetteFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
John T StreetFrom the Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC (Moskven, Banaszek, Ailon, Charest-Morin, Dea, Dvorak, Fisher, Kwon, Paquette, Street); Arthritis Research Canada, Richmond, BC (Sayre); the Department of Infection Control, Quality and Patient Safety, Vancouver General Hospital, Vancouver, BC (Gara); and the Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC (Bryce, Wong).
Research Canada · CAUniversity of British Columbia · CAVancouver General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent measures to prevent spinal surgical site infection (SSI) lack compliance and lead to antimicrobial resistance. We aimed to examine the effectiveness of bundled preoperative intranasal photodynamic disinfection therapy (nPDT) and chlorhexidine gluconate (CHG) body wipes in the prophylaxis of spine SSIs in adults, as well as determine our institutional savings attributable to the use of this strategy and identify adverse events reported with nPDT-CHG.

methodsWe performed a 14-year prospective observational interrupted time-series study in adult (age > 18 yr) patients undergoing emergent or elective spine surgery with 3 time-specific cohorts: before rollout of our institution's nPDT-CHG program (2006-2010), during rollout (2011-2014) and after rollout (2015-2019). We used unadjusted bivariate analysis to test for temporal changes across patient and surgical variables, and segmented regression to estimate the effect of nPDT-CHG on the annual SSI incidence rates per period. We used 2 models to estimate the cost of nPDT-CHG to prevent 1 additional SSI per year and the annual cumulative cost savings through SSI prevention.

resultsOver the study period, 13 493 patients (mean 964 per year) underwent elective or emergent spine surgery. From 2006 to 2019, the mean age, mean Charlson Comorbidity Index (CCI) score and mean Spine Surgical Invasiveness Index (SSII) score increased from 48.4 to 58.1 years, from 1.7 to 2.6, and from 15.4 to 20.5, respectively (

conclusionPreoperative nPDT-CHG administration is an effective prophylactic strategy for spinal SSIs, with significant cost savings. Given its rapid action, minimal risk of antimicrobial resistance, broad-spectrum activity and high compliance rate, preoperative nPDT-CHG decolonization should be the standard of care for all patients undergoing emergent or elective spine surgery.

Indexed as

Anti-Infective AgentsDisinfectionAdultChlorhexidineHumansMiddle AgedSurgical Wound InfectionAnti-Infective AgentsChlorhexidinechlorhexidine gluconate

Identifiers

PMID37967971
PMCPMC10664804
OpenAlexW4388705662

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.