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John E. O'Toole, Kurt M. Eichholz, and Richard G. Fessler

, and syringosubarachnoid shunt insertions. MI = minimally invasive. The prospective databases included documentation of all perioperative complications. The incidences of postoperative SSIs were therefore calculated for the entire cohort as well as for subgroups based on the type of procedure performed. Positive cases of SSI were reviewed for clinically relevant details. A MEDLINE search was performed for English language citations using the key words “surgical site infection,” “wound infection,” and “postoperative infection” with “spine surgery,” “spinal surgery

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Masahiko Watanabe, Daisuke Sakai, Daisuke Matsuyama, Yukihiro Yamamoto, Masato Sato, and Joji Mochida

P ostoperative surgical site infection is a serious complication in all kinds of surgery. During spine surgery, surgical site infection also causes specific problems, including the need for long-term intravenous antibiotics, sepsis, repeated surgical procedures, hardware removal, pseudarthrodesis, progression of deformity, and prolonged hospitalization. The cost of care may increase more than 4-fold 4 with surgical site infection, and the overall mortality risk is doubled. 17 Rates of surgical site infection reported from individual institutions have

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Kalil G. Abdullah, Mark A. Attiah, Andrew S. Olsen, Andrew Richardson, and Timothy H. Lucas

subgaleal vancomycin. The craniotomy groups were well balanced in terms of demographic variables known to influence infection rates. Also, each group received identical preoperative and postoperative care. Accordingly, this sample adequately reflects a general craniotomy population that might be seen by a large-volume academic center. In our discussion, we consider these findings in the context of the published literature on topical antibiotics in neurosurgical care. Surgical site infections comprise a high proportion of hospital-associated infections. The incidence of

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Hsiu-Yin Chiang, Aparna S. Kamath, Jean M. Pottinger, Jeremy D. W. Greenlee, Matthew A. Howard III, Joseph E. Cavanaugh, and Loreen A. Herwaldt

M ore than 100,000 craniotomy and craniectomy procedures are performed in the US each year. Surgical site infections (SSIs) complicate from 2.2% among low-risk patients to 4.7% among high-risk patients undergoing these procedures ( ). 8 , 15 Most SSIs after a craniotomy or craniectomy (CRANI) affect organ spaces (that is, subgaleal space, subdural space, cranial bone, or brain). Consequently, these infections often require surgical treatment and increase morbidity, mortality, and cost. Patient-related risk factors for SSIs after

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Nickalus R. Khan, Clinton J. Thompson, Michael DeCuypere, Jonathan M. Angotti, Erick Kalobwe, Michael S. Muhlbauer, Francis X. Camillo, and Paul Klimo Jr.

searched PubMed/MEDLINE, , The Cochrane Library, Web of Science, and Scopus to find English-language articles (excluding “gray literature”) with no timeframe restrictions. The following terms in various combinations were used: “vancomycin powder,” “spine surgery,” “neurosurgery,” “surgery,” and “surgical site infection.” Two independent researchers (N.R.K. and J.M.A.) along with librarians at the University of Tennessee Health Science Center conducted independent literature searches. If there was any question as to the eligibility of an article

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Elizabeth Carroll and Ariane Lewis

A ppreciating the fund of knowledge and resources available to minimize the risk of surgical site infections (SSIs) after brain surgery in the 21st century requires an understanding of the history of SSI prevention. Herein, we review the history of SSI prevention from the initial days of brain surgery in the prehistoric period to the present ( Table 1 ). TABLE 1. Timeline of SSI prevention techniques after brain surgery Period Prevention Technique Prehistoric period - Gold (a biocidal agent) was used for cranioplasty inlay Egyptian & Babylonian period - The

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Ahmed Kashkoush, Nitin Agarwal, Ashley Ayres, Victoria Novak, Yue-Fang Chang, and Robert M. Friedlander

N osocomial infections are devastating complications that increase patient morbidity and mortality. 8 , 9 , 16 , 51 Of all healthcare-associated infections, surgical site infections (SSIs) are among the most common causes of morbidity, prolonged hospital stays, and increased healthcare costs. 8 , 51 The annual cost of SSIs in the United States is approximated to be $3.5 to $10 billion. 3 , 4 Some estimate that SSIs increase mortality by 4.3% and can increase healthcare costs by as much as 3-fold. 20 , 27 , 52 Avoiding SSIs is not always possible, but the

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Byung-Uk Kang, Sang-Ho Lee, Yong Ahn, Won-Chul Choi, and Young-Geun Choi

S urgical site infection is a significant complication in spinal surgery as it is associated with prolonged morbidity and poor functional outcome. The occurrence is relatively frequent, and the reported incidence varies from 0.7 to 6%. 2 , 6 , 10 , 17 , 22 , 26 , 27 Surgical site infection often requires long-term antibiotic therapy, surgical debridement, and a prolonged hospital stay. Appropriate prevention and early detection of infectious complications can lead to improved outcomes. Of great interest is a simple and reliable screening test for detection

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Hiroki Ushirozako, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Tatsuya Yasuda, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yuki Mihara, Tomohiro Yamada, Koichiro Ide, Yuh Watanabe, Keichi Nakai, Takaaki Imada, and Yukihiro Matsuyama

interpretation of data: Ushirozako. Drafting the article: Ushirozako. Critically revising the article: Hasegawa. Reviewed submitted version of manuscript: Hasegawa, Yamato, Yoshida, Yasuda, Banno, Arima, Oe, Mihara, Yamada, Ide, Watanabe, Nakai, Imada, Matsuyama. Statistical analysis: Ushirozako. Study supervision: Matsuyama. References 1 Olsen MA , Mayfield J , Lauryssen C , Risk factors for surgical site infection in spinal surgery . J Neurosurg . 2003 ; 98 ( 2)(suppl ): 149 – 155 . 2 Xing

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Brandon A. Sherrod and Brandon G. Rocque

H ospital - acquired infections are an increasingly prevalent and costly problem. 28 Surgical site infection (SSI) is a hospital-acquired infection causing significant morbidity, mortality, and added cost of care. 15 , 19 , 22 , 28 Although SSI itself is considered an undesired surgical complication, subsequent SSI-related adverse events such as bloodstream infection, septic shock, readmission, or reoperation are potentially more harmful than the SSI itself. The gravity of SSI, especially when considering the potential preventability of the infection