Multifidus restoration combined with intraoperative soft tissue debridement to reduce surgical site infections in spine surgery: A retrospective study

Abstract

Abstract Background: Surgical site infections (SSIs) are serious postoperative complications that significantly increase the suffering of patients and increase hospitalization costs. Debridement is effective in treating surgical incision infections, but intraoperative soft tissue debridement for preventing postoperative infections after spinal surgery is rarely reported. Purpose: This study aimed to determine the efficacy of multifidus restoration combined with soft tissue debridement in reducing the incidence of SSIs in spinal surgery. Study Design: This was a retrospective study. Patient Sample: All patients undergoing spinal surgery in our orthopedic department over a 9-year period were included in this study. Outcome Measures: The SSI rate, operative time, fixed segment, incision length, subcutaneous fat thickness at the incision site, intraoperative blood loss, drainage tube indwelling time, volume of drainage, surgical site visual analogue scale (VAS) score, and white blood cell count were observed and recorded. Methods: We retrospectively analyzed the clinical data of patients undergoing spinal surgery at our institution from January 2013 to December 2021. The patients were assorted into the following groups: group 1, patients who underwent multifidus restoration combined with soft tissue debridement (MR/STD) during spinal surgery from January 2018 to December 2021; group 2, patients who did not receive the aforementioned treatment during the surgery, from January 2013 to December 2018. The primary outcome was SSIs. Results: A total of 500 patients were included. In group 1 (N = 254), 4 (1.6 %) patients developed SSI. In group 2 (N= 246), 13 (5.3%) patients developed SSI. No significant differences were found in age, sex, average surgery time, fixed segment, incision length, blood loss, drainage tube indwelling time, and total drainage fluid between the two groups (P > 0.05). Statistically significant differences between the two groups were observed in SSI rate, white blood cell count, and VAS scores (P < 0.05). Conclusions: MR/STD could reduce the rate of spinal surgery site infection and partially relieve postoperative surgical site pain symptoms. Moreover, these procedures did not incur additional surgical trauma.