Introduction

Surgical site infections (SSI) following instrumented fixation of the spine pose major problem to the spinal surgeon. In particular, deep SSI after spinal instrumentation were refractory to control infection, while were often required removal of instrumentation. We attempted to reduce SSI following spinal instumentation, using the povidone-iodine irrigation protocol. The aim of this study was to evaluate the long-term results of this protocol for preventing SSI following instrumented stabilization of the spine.

Methods

All cases of spinal instrumentation at our institution between October 2011 and September 2019were retrospectively reviewed. The patients were subdivided into those who had received saline irrigation after 90 seconds of 1% povidone-iodine pooling and normal saline irrigation every 1.5 hours (study group) and only routine saline irrigation every 1.5 hours (control group). The study and control groups comprised 289 and 247 patients, respectively. This study compared the rate of SSI with and without the use of povidone-iodine irrigation protocol.

Results

SSI rates were 1.03% of the study group (3 for 289 patients) and 2.47% of the control group (6 for 247 patients). SSI rates were decreased, although statistically significant different (p=0.948). Deep SSI occurred 0 cases in study group and in 3 cases in the control group. Deep SSI rates were significantly reduced in study group (p=0.046). No adverse events of were occurred in study group and there was no incidence of MRSA infection in study group.

Conclusion

In this small preliminary study, our findings underscored the clinical benefits of our treatment strategy using the povidone-iodine irrigation protocol. Deep SSI were significantly reduced and there was no MRSA infection in this study. This method can be a simple and safe SSI prevention method.