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Role of local streptomycin in prevention of surgical site infection in TB spine

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Abstract

Purpose

Surgical site infection (SSI) continues to be one of the most common post-operative complications in most spine surgeries. Patients with tuberculosis (TB) of spine are more at risk of developing this complication due to a number of reasons. This adds to significant morbidity and economic burden on patients adversely affecting the mental status and quality of life of patients. The aim of this study was to investigate the role of local streptomycin in preventing SSI in patients undergoing surgical management of spinal TB.

Methods

In total, 56 patients who underwent surgical management for radiologically proven TB spine divided into two groups were included in the study. Group A included 30 patients with no local streptomycin administered intraoperatively, while group B included 26 patients operated in the later part of study with the use of local streptomycin intraoperatively. The two groups were compared and the outcome criteria analysed were SSI rate, length of hospital stay, duration of post-operative antibiotics and need for debridement.

Results

Length of hospital stay (group A: 18.4 ± 6.9 days; group B: 9.7 ± 3.9 days) and duration of post-operative antibiotics (group A: 8.1 ± 1.6 days; group B: 6.2 ± 2.1 days) were significantly higher in group A when compared with group B. SSI rate (group A: 13.34%; group B: 3.84%) and need for debridement (group A: 10%; group B: 3.84%) were higher in group A, but the difference was not statistically significant.

Conclusion

Intraoperative administration of local streptomycin significantly reduces the length of hospital stay and duration of antibiotic administration in post-operative period in patients undergoing surgery for TB spine.

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Correspondence to Pankaj Kandwal.

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Ahuja, K., Yadav, G., Sudhakar, P.V. et al. Role of local streptomycin in prevention of surgical site infection in TB spine. Eur J Orthop Surg Traumatol (2020) doi:10.1007/s00590-019-02617-x

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Keywords

  • Intrawound antibiotics
  • Streptomycin
  • Tuberculosis spine