Prophylactic postoperative measures to minimize surgical site infections in spine surgery: systematic review and evidence summary

BACKGROUND CONTEXT: There are three phases in prophylaxis of surgical site infections (SSI): preoperative, intraoperative and postoperative. There is lack of consensus and paucity of evidence with SSI prophylaxis in the postoperative period. PURPOSE: To systematically evaluate the literature, and provide evidence-based summaries on postoperative measures for SSI prophylaxis in spine surgery. STUDY DESIGN: Systematic review, meta-analysis, evidence synthesis. METHODS: A systematic review conforming to PRIMSA guidelines was performed utilizing PubMed (MEDLINE), EMBASE, and the Cochrane Database from inception to January 2019. The GRADE approach was used for quality appraisal and synthesis of evidence. Six postoperative care domains with associated key questions were identified. Included studies were extracted into evidence tables, data synthesized quantitatively and qualitatively, and evidence appraised per GRADE approach. RESULTS: Forty-one studies (nine RCT, 32 cohort studies) were included. In the setting of preincisional antimicrobial prophylaxis (AMP) administration, use of postoperative AMP for SSI reduction has not been found to reduce rate of SSI in lumbosacral spine surgery. Prolonged administration of AMP for more than 48 hours postoperatively d

The Spotted Nightjar calls when dingo pups are born: ecological and social indicators in Central Australia

Across cultures there are known signs that signal the availability of certain foods, predict the weather or warn people of impending events. In Central Australia the call of the spotted nightjar (Eurostopodus argus) signals the time when dingo pups are born. This article identifies indicator events known by speakers of the Arandic languages in Central Australia. Indicator events can be described as the presence or behavior of a particular species or phenomenon that signals some other species or phenomenon. Arandic people group these into five broad domains: indicators of food, water, weather, danger and news (e.g., an imminent visitor). A diverse range of ecological, meteorological and human (bodily) phenomena serve as indicators, with birds being the most prevalent. This study explores the basis of indicator events, finding both an ecological and cultural basis for many signs. It also draws attention to the significance of the indicator relationship in terms of how people make sense of co-occurring events around them. We also consider some implications for natural resource management and phenology