Evidence map›Paper›PMID 41870865›Full record

ArticleSpine deformity2026

Does the combination of pulsed lavage and negative pressure dressings reduce infection rates after posterior spinal arthrodesis in pediatric scoliosis ?

Simon Arvati, Esther Hubert-Delisle, Nolwen Lemonnier, Francesco Monti, Isabelle Bernardini, Mourad Ould Slimane, Francois Luc

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Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

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

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Simon ArvatiDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. simon.arvati@chu-rouen.fr.ORCID http://orcid.org/0009-0000-9718-0033
Esther Hubert-DelisleDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Nolwen LemonnierDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Francesco MontiDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Isabelle BernardiniDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Mourad Ould SlimaneDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Francois LucDepartment of Pediatric Orthopedic Surgery, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical site infections (SSIs) remain a major complication after posterior spinal fusion for scoliosis. In 2019, our center implemented a peri-operative change combining pulsed lavage and closed-incision negative pressure therapy (cINPT). We compared SSI rates before versus after this protocol and explored outcomes.

methodsWe conducted a retrospective single-center cohort study including consecutive adolescents undergoing posterior fusion (2011-2025). Patients operated before 2019 received standard irrigation and a standard dressing; after 2019 they received pulsed lavage plus closed-incision negative pressure therapy (cINPT). The primary outcome was surgical site infection (SSI) within 90 days of surgery, defined according to CDC/NHSN criteria (superficial incisional, deep incisional, or organ/space). Secondary outcomes included SSI timing (early ≤ 30 days vs late (31-90 days) and microbiology.

resultsThe overall SSI rate was 11.0%, and it was higher in the neuromuscular subgroup than in idiopathic cases. SSI incidence decreased from 15.5% in the pre-2019 period to 5.7% after implementation of pulsed lavage plus cINPT. In multivariable modelling adjusted for pelvic extension, fusion length, and number of senior surgeons (but not operative time), the association persisted; when operative time was added, the association was attenuated and no longer statistically significant. Among infected cases, Staphylococcus aureus and Cutibacterium acnes were the most frequent pathogens, and most SSIs occurred within 30 days.

conclusionIn this single-center cohort, implementing pulsed lavage plus cINPT was associated with lower SSIs after posterior fusion for scoliosis, with a signal particularly relevant in neuromuscular patients. Although residual confounding cannot be excluded, these findings support integrating enhanced intra-operative irrigation and closed-incision therapy into multimodal SSI-prevention bundles. LEVEL OF EVIDENCE: III (retrospective cohort).

Indexed as

Negative-Pressure Wound TherapyScoliosisSpinal FusionSurgical Wound InfectionTherapeutic IrrigationAdolescentBandagesChildFemaleHumansMaleRetrospective StudiesNegative pressure therapyPosterior spinal fusionPulsed lavageScoliosisSurgical site infection

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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.