Surgical Site Infection Management in Spinal Surgery
Summary
Surgical site infections (SSIs) represent a serious complication of spinal surgery, contributing to prolonged hospital stays, increased morbidity and substantial health-care costs. Management begins with rigorous patient assessment to identify modifiable risk factors such as diabetes, malnutrition and tobacco use. Intraoperative strategies include meticulous skin preparation, adherence to sterile technique, minimisation of operative time and careful handling of implants. The prevention of biofilm formation on instrumentation is a key goal, combining local antiseptics, antibiotic-impregnated materials and advanced coating technologies. Early diagnosis relies on clinical vigilance, monitoring of inflammatory markers and timely imaging. When infection is confirmed, a multidisciplinary approach is essential: surgical debridement, judicious implant retention or removal, and targeted antimicrobial therapy tailored to the organism and its resistance profile. Adjunctive measures—such as negative-pressure wound therapy and specialised wound dressings—may enhance clearance and foster healing. Optimisation of nutritional status and glycaemic control supports host defences, while ongoing research into novel coatings, local delivery systems and rapid diagnostic tools continues to shape best practice. Overall, successful management of SSIs in spinal surgery demands integration of prevention, early detection and coordinated surgical-medical interventions.
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Surgical Site Infection Management in Spinal Surgery publication trend
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Technical terms
Surgical Site Infection (SSI): Infection occurring at or near a surgical incision within 30 days of operation, involving superficial or deep tissues.
Biofilm: A structured community of microorganisms adhered to surfaces and encased in a self-produced matrix, highly resistant to antibiotics.
Debridement: Surgical removal of necrotic, infected or non-viable tissue to reduce microbial load and promote healing.
Instrumentation Retention: Preservation of spinal implants during infection management, often combined with thorough debridement and antibiotic therapy.
Silver Fixation System: Orthopaedic hardware coated with silver ions or nanoparticles to exploit silver’s broad-spectrum antimicrobial properties.
References
- First Clinical Evidence About the Use of a New Silver-Coated Titanium Alloy Instrumentation to Counteract Surgical Site Infection at the Spine Level. Journal of Functional Biomaterials (2025).
- Cutibacterium spp. Infections after Instrumented Spine Surgery Have a Good Prognosis Regardless of Rifampin Use: A Cross-Sectional Study. Antibiotics (2023).
- Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study. Bioengineering (2023).
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