Is a Drain Tip Culture Required After Spinal Surgery?

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Abstract

Study Design:

The efficacy of use of a drain tip culture for early detection of surgical-site infection (SSI) was investigated in 329 patients after spinal surgery.

Objective:

To examine the efficacy of a wound drain tip culture for detection of SSI in spinal surgery.

Summary of Background Data:

A complication of SSI after spinal surgery has high associated morbidity and mortality, and is often difficult to treat.

Materials and Methods:

The subjects were patients who underwent spinal surgery at our institution between January 2010 and March 2013. All subjects were treated with antimicrobial prophylaxis based on evidence-based guidelines and were followed for at least 6 months after surgery. Data from culture studies using the distal tip of the wound drain were used for analysis.

Results:

Drain tip cultures were positive in 34 cases and there were 19 SSIs. Ten of the 34-tip culture-positive wounds developed SSI. Drain tip cultures had a sensitivity of 52%, specificity of 92%, positive predictive value (PPV) of 29%, and negative predictive value of 97% for predicting a wound infection. The association between a positive suction tip culture and wound infection was significant (P<0.05). The PPV for SSI was 60% in cases in which methicillin-resistant bacteria were detected in a drain tip, and the SSI rate in these cases differed significantly compared with those with non–methicillin-resistant bacteria (P=0.01).

Conclusions:

A drain tip culture is useful for early detection of SSI caused by methicillin-resistant bacteria.

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