Prevention of implant-associated spinal infections: the GAID-protocol
ObjectiveThe purpose of this study is to investigate the efficacy of the GAID-Protocol, a bundle of intra- and postoperative infection prevention measures, to reduce implant-associated infections in patients undergoing posterior spinal fusion with instrumentation. These preventive measures are organ...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1308213/full |
| _version_ | 1797502862442364928 |
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| author | Joanna Maria Przybyl Aldemar Andres Hegewald |
| author_facet | Joanna Maria Przybyl Aldemar Andres Hegewald |
| author_sort | Joanna Maria Przybyl |
| collection | DOAJ |
| description | ObjectiveThe purpose of this study is to investigate the efficacy of the GAID-Protocol, a bundle of intra- and postoperative infection prevention measures, to reduce implant-associated infections in patients undergoing posterior spinal fusion with instrumentation. These preventive measures are organized into a protocol that includes recommendations for four critical areas of implant protection (acronym GAID): Gloves, Antiseptics: sodium hypochlorite/hypochlorous acid (NaOCl/HOCl), Implants and Drainage-use in large wounds.MethodsWe performed a single-site retrospective review of cases undergoing posterior spinal fusion with instrumentation for primarily degenerative spinal diseases before and after implementation of the GAID-Protocol that was specifically designed to protect against implant-associated infections. The primary outcome was postoperative wound complications requiring surgical intervention, with a particular focus on infectious spondylitis/discitis.Results230 cases were included: 92 (Group A) before and 138 (Group B) after protocol implementation. Overall, wound complications requiring surgical intervention occurred in 7.6% patients in Group A and in 3.6% patients in Group B (p = 0.2297). Of these, infectious spondylitis/discitis was present in 5.4% in Group A and in none of Group B (p = 0.0096). The ratio of infectious spondylitis/discitis to other wound problems was 71% to 29% in Group A, while it was 0% to 100% in Group B (p = 0.0278). The mean time interval between the first revision surgery for wound complications and hospital discharge was significantly different, 38 days SD 20.3 in Group A and 14.4 days SD 8.6 in Group B (p = 0.0442).ConclusionsIn our study, adherence to the GAID-Protocol resulted in a shift from severe to significantly less severe and easier to treat wound complications. Adoption of the GAID-Protocol might contribute to the reduction of implant-associated infections. |
| first_indexed | 2024-03-10T03:42:12Z |
| format | Article |
| id | doaj.art-a11ab248b2ef49deabd9b88620f71577 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-10T03:42:12Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-a11ab248b2ef49deabd9b88620f715772023-11-23T09:16:02ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-11-011010.3389/fsurg.2023.13082131308213Prevention of implant-associated spinal infections: the GAID-protocolJoanna Maria PrzybylAldemar Andres HegewaldObjectiveThe purpose of this study is to investigate the efficacy of the GAID-Protocol, a bundle of intra- and postoperative infection prevention measures, to reduce implant-associated infections in patients undergoing posterior spinal fusion with instrumentation. These preventive measures are organized into a protocol that includes recommendations for four critical areas of implant protection (acronym GAID): Gloves, Antiseptics: sodium hypochlorite/hypochlorous acid (NaOCl/HOCl), Implants and Drainage-use in large wounds.MethodsWe performed a single-site retrospective review of cases undergoing posterior spinal fusion with instrumentation for primarily degenerative spinal diseases before and after implementation of the GAID-Protocol that was specifically designed to protect against implant-associated infections. The primary outcome was postoperative wound complications requiring surgical intervention, with a particular focus on infectious spondylitis/discitis.Results230 cases were included: 92 (Group A) before and 138 (Group B) after protocol implementation. Overall, wound complications requiring surgical intervention occurred in 7.6% patients in Group A and in 3.6% patients in Group B (p = 0.2297). Of these, infectious spondylitis/discitis was present in 5.4% in Group A and in none of Group B (p = 0.0096). The ratio of infectious spondylitis/discitis to other wound problems was 71% to 29% in Group A, while it was 0% to 100% in Group B (p = 0.0278). The mean time interval between the first revision surgery for wound complications and hospital discharge was significantly different, 38 days SD 20.3 in Group A and 14.4 days SD 8.6 in Group B (p = 0.0442).ConclusionsIn our study, adherence to the GAID-Protocol resulted in a shift from severe to significantly less severe and easier to treat wound complications. Adoption of the GAID-Protocol might contribute to the reduction of implant-associated infections.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1308213/fullsurgical site infectionspinal infectionsimplant-associated infectionsodium hypochlorite/hypochlorous acidspinal fusionspondylodiscitis |
| spellingShingle | Joanna Maria Przybyl Aldemar Andres Hegewald Prevention of implant-associated spinal infections: the GAID-protocol Frontiers in Surgery surgical site infection spinal infections implant-associated infection sodium hypochlorite/hypochlorous acid spinal fusion spondylodiscitis |
| title | Prevention of implant-associated spinal infections: the GAID-protocol |
| title_full | Prevention of implant-associated spinal infections: the GAID-protocol |
| title_fullStr | Prevention of implant-associated spinal infections: the GAID-protocol |
| title_full_unstemmed | Prevention of implant-associated spinal infections: the GAID-protocol |
| title_short | Prevention of implant-associated spinal infections: the GAID-protocol |
| title_sort | prevention of implant associated spinal infections the gaid protocol |
| topic | surgical site infection spinal infections implant-associated infection sodium hypochlorite/hypochlorous acid spinal fusion spondylodiscitis |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1308213/full |
| work_keys_str_mv | AT joannamariaprzybyl preventionofimplantassociatedspinalinfectionsthegaidprotocol AT aldemarandreshegewald preventionofimplantassociatedspinalinfectionsthegaidprotocol |