JPOSNA Quiz - Preventing SSI: What Do We Know, What Don’t We Know?

Abstract

Surgical site infections (SSIs) are a devastating and resource-intensive complication of surgical intervention. The most recent, comprehensive data available suggests that the risk of surgical site infection in all orthopaedic procedures is approximately 1%.¹ In pediatric orthopaedic spine fusion procedures, SSI rates range from 1% in idiopathic scoliosis up to 19% in patients with myelomeningocele.² Financial costs associated with surgical treatment of SSIs in spine fusion patients are estimated to be from $66,000 up to $1 million.³ Implant-heavy surgeries significantly increase the risk of a SSI, and accordingly, the surgeon aims to be extremely vigilant with these higher-risk situations. The majority of orthopaedic implants are made of materials that are avascular in nature and are therefore susceptible to infection and the formation of biofilms making eradication of the infection significantly more difficult.⁴ The purpose of this quiz is to probe our knowledge of the history of antisepsis, the evolution of infection prevention, and current best practices applicable in pediatric orthopaedic surgery. How many of our actions are truly dogma and how many are evidenced based practice? What elements are historical and what elements are best practices?