Evidence map›Paper›PMID 38457028›Full record

ArticleSpine deformity2024

The effect of antibiotic-impregnated calcium sulfate beads and Medical Optimization Clinic attendance on the acute surgical site infection rate in high-risk pediatric neuromuscular and syndromic scoliosis patients.

Yashas Reddy, Adam Jamnik, David Thornberg, Anne-Marie Datcu, Emily Lachmann, Megan Johnson, Brandon Ramo, Amy L McIntosh

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Article in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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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

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Yashas ReddySidney Kimmel Medical College, Thomas Jefferson University Hospital, 1015, Walnut Street, Philadelphia, PA, 19107, United States.
Adam JamnikDepartment of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, United States.ORCID 0000-0002-5370-5958
David ThornbergScottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States.ORCID 0000-0002-6876-0458
Anne-Marie DatcuSchool of Medicine, Texas A&M University, 8447 Riverside Parkway, Byran, TX, 77807, United States.
Emily LachmannDepartment of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, United States.
Megan JohnsonScottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States.ORCID 0000-0002-5968-9469
Brandon RamoScottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States.ORCID 0000-0003-1445-230X
Amy L McIntoshSidney Kimmel Medical College, Thomas Jefferson University Hospital, 1015, Walnut Street, Philadelphia, PA, 19107, United States. Amy.McIntosh@tsrh.org.ORCID 0000-0002-3660-4901

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuromuscular and syndromic (NMS) scoliosis patients are at higher risk of acute surgical site infections (SSIs). Despite following POSNA's endorsed consensus-based guidelines for SSI prevention, our institutional rates of acute SSI have varied dramatically. This variability drove simultaneous strategies to lower SSI rates: the creation of a preoperative Medical Optimization Clinic (MOC) and use of antibiotic-impregnated (Abx-I) calcium sulfate beads.

methodsPatients undergoing index PSF at a single institution between 2016 and 2022 were retrospectively reviewed. Patients with ≥ 2 risk factors were included: (1) BMI < 18.5 or > 25; (2) incontinence; (3) instrumentation to pelvis; (4) non-verbal; (5) GMFCS IV/V. SSI was defined as deep infection within 90 days. We compared patients who attended MOC and received Abx-I (MOC + Abx-I) to those receiving neither intervention (control) nor a single intervention.

results282 patients were included. The overall infection rate was 4.26%. Higher GMFCS (p = 0.0147), non-verbal status (p = 0.0048), and longer fusions (p = 0.0298) were independently associated with infection rate. Despite the MOC + Abx-I group having larger Cobb angles (88° ± 26°), higher GMFCS levels (4.5 ± 0.9), ASA class (3 ± 0.4), and more frequent instrumentation to the pelvis (85%), they had the lowest infection rate (2.13%) when compared to the control (4.2%) or single intervention groups (5.7%, 4.6%) (p = 0.9).

conclusionThe study examined the modern infection rate of NMS patients following the implementation of two interventions: MOC and Abx-I. Despite having higher risk factors (curves (88°), GMFCS level (4.5), ASA class (3), higher % instrumentation to the pelvis (85%)), the patients treated with both interventions demonstrated the lowest infection rate (2.13%).

Indexed as

Anti-Bacterial AgentsCalcium SulfateScoliosisSurgical Wound InfectionAdolescentAntibiotic ProphylaxisChildFemaleHumansMalePreoperative CareRetrospective StudiesRisk FactorsSpinal FusionAnti-Bacterial AgentsCalcium SulfateAcute surgical site infectionNeuromuscularPosterior spinal fusionSyndromic scoliosis

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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.