The superiority of one regimen or protocol of prophylactic antibiotics over any other for SSI in spinal surgery has not been clearly demonstrated. We designed a controlled clinical trial to compare the occurrence of SSI and the changes of hematologic results depending on prophylaxis regimens and protocols. The aim of this study was to compare the efficacy of prophylactic antibiotics in spinal surgery for the occurrence of postoperative surgical site infection (SSI) and host immune reactions depending on various administration regimens and protocols. Between January 2007 and February 2011, two hundred consecutive patients who had undergone a thoracolumbar/lumbar surgery for degenerative or traumatic disease were included. Postoperative protocol had been altered for each group of fifty consecutive patients; 1st generation cephalosporins for 5-days (group A), 2nd generation cephalosporins for 5-days (group B), 1st generation cephalosporins for 3-days (group C), and 2nd generation cephalosporins for 3-days (group D). Preoperative antibiotics prophylaxis was administrated within 1 hour prior to surgical incision with the same trial antibiotics. Intraoperative bacterial culture on the surgical site was performed. The occurrences of SSI were evaluated as either incisional or organ/space SSI. Serial changes of hematologic inflammatory markers (WBC, ESR, CRP) and DIC markers (fibrinogen, FDP, D-dimer) were compared until postoperative 2 weeks. The study groups were homogeneous regarding age, sex, body mass index, estimated blood loss, diabetes mellitus, smoking, diagnoses, baseline laboratory values, and type of surgery including instrumentation. Overall 13 cases of incisional SSI (6.5%) and 3 cases (1.5%) of organ/space SSI had occurred. There was no difference in the occurrence of incisional and organ/space SSI among the 4 groups (P=0.690, 0.799). Laboratory results revealed that postoperative changes of hematologic inflammatory markers and DIC markers were not influenced by prophylaxis regimens and protocols (all P>0.05). The occurrences of SSI and host immune responses were not influenced by postoperative antibiotics regimens and protocols. Hematologic investigation revealed that the host immune responses were not different depending on the prophylactic antibiotics.
예방적 정주항생제, 수술 부위 감염, 혈액학적 인자, 척추 수술, prophylactic antibiotics, surgical site infection, hematologic markers, spine surgery
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