Medical Student Drexel University College of Medicine Cheshire, Connecticut, United States
Introduction: Closed-suction drains are commonly placed after thoracolumbar surgery to reduce the risk of post-operative hematoma and neurologic deterioration, and may stay in place for a longer period of time if output remains high. Prolonged maintenance of surgical site drains; however, is associated with an increased risk of surgical site infection (SSI). The present study aims to examine the literature regarding extended duration (≥ 24 hours) prophylactic antibiotic use in patients undergoing posterior thoracolumbar surgery with closed-suction drainage.
Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Relevant studies reporting the use of 24-hour post-operative antibiotics compared with extended duration post-operative antibiotics in patients undergoing posterior thoracolumbar surgery with closed-suction drainage were identified from a PubMed database query.
Results: Six studies were included for statistical analysis, encompassing 1003 patients that received 24 hours of post-operative antibiotics and 984 patients that received ≥ 24 hours of post-operative antibiotics. The SSI rate was 5.16% for the shorter duration group (24 hours) and 4.44% (p=0.7865) for the longer duration group (≥ 24 hours).
Conclusion : There is no significant difference in rates of SSI in patients receiving 24 hours of post-operative antibiotics after thoracolumbar surgery with closed-suction drains compared with patients receiving ≥ 24 hours of post-operative antibiotics.
