Epidemiology Of Postoperative Infection In Patients With Myelomeningocele, Treated For The Correction Of Spinal Deformities [epidemiologia Da Infecção Pós-operatória Em Pacientes Com Mielomeningocele, Tratados Para Correção De Deformidades Da Coluna Vertebral]

Objective: The spinal surgeries performed in patients with myelomeningocele are at higher risk of postoperative infection. We made an epidemiological survey of these infections and factors possibly associated to establish risk factors. Methods: A retrospective review of data from spinal surgeries performed in patients with myelomeningocele, in the Associação de Assistência à Criança Deficiente -AACD/ Hospital Abreu Sodré. The comparison of possible risk factors evaluated was made by Fisher's exact test. Results were considered significant at p<0.05. Results: We evaluated 27 surgical procedures with a total of 7 cases of postoperative surgical site infection (25.92%). Five of these patients with surgical site infection had concomitant urinary tract infection (UTI) with p=0.004. We found no statistical significance for the other factors evaluated: surgical approaches, type of procedure and total serum lymphocytes. Conclusion: UTI is related to surgical site infection, but we need a prospective study with more cases to clarify this risk factor with a possible confounding factor: the nutritional and immunologic status.104269272Benson, E.R., Thomson, J.D., Smith, B.G., Banta, J.V., Results and morbidity in a consecutive series of patients undergoing spinal fusion for neuromuscular scoliosis (1998) Spine (Phila Pa 1976), 23 (21), pp. 2308-2317Sponseller, P.D., Laporte, D.M., Hungerford, M.W., Eck, K., Bridwell, K.H., Lenke, L.G., Deep wound infections after neuromuscular scoliosis surgery: A multicenter study of risk factors and treatment outcomes (2000) Spine (Phila Pa 1976), 25 (19), pp. 2461-2466Sanchez-Sotelo, J., Sanchez Perez-Grueso, F.J., Cotrel-Dubousset instrumentation in neuromuscular spinal deformity. A five to eleven-year follow-up study (2000) Acta Orthopaedica Belgica, 66 (1), pp. 69-76Noonan, K.J.M., Myelomeningocele (2006) Lovell and Winteŕs Pediatric Orthopaedics, pp. 605-647. , Morrissy RT, Weinstein SL. Philadelphia: Lippincott Williams & Wilkins, 6a. edJevsevar, D.S., Karlin, L.I., The relationship between preoperative nutritional status and complications after an operation for scoliosis in patients who have cerebral palsy (1993) Journal of Bone and Joint Surgery - Series A, 75 (6), pp. 880-884Hatlen, T., Song, K., Shurtleff, D., Duguay, S., Contributory factors to postoperative spinal fusion complications for children with myelomeningocele (2010) Spine (Phila Pa 1976), 35 (13), pp. 1294-1299Klein, J.D., Hey, L.A., Yu, C.S., Klein, B.B., Coufal, F.J., Young, E.P., Marshall, L.F., Garfin, S.R., Perioperative nutrition and postoperative complications in patients undergoing spinal surgery (1996) Spine, 21 (22), pp. 2676-2682. , DOI 10.1097/00007632-199611150-00018Modi, H.N., Suh, S.W., Yang, J.H., Cho, J.W., Hong, J.Y., Singh, S.U., Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation (2009) Scoliosis, 4, p. 11Dias, R.C.C., Veiga, I.G., Pasqualini, W., Santos, M.A.M., Landim, E., Cavali, P.T.M., Avaliação do tratamento cirúrgico da cifose congênita na mielomeningocele com o uso da via posterior pela técnica de Dunn-McCarthy modificada (2008) Coluna/Columna, 7 (2), pp. 146-152Landim, E., Cavali, P.T.M., Santos, M.A.M., Pasqualini, W., Boechat, R.C.B.M., Andrade, S.M.S., Uso da prótese expansível de titânio para costela (VEPTR) como opção na instrumentação sem fusão para tratamento da escoliose neuromuscular (2008) Coluna/Columna, 7 (2), pp. 160-166Garner, J.S., Jarvis, W.R., Emori, T.G., Horan, T.C., Hughes, J.M., CDC definitions for nosocomial infections, 1988 (1988) Am J Infect Control, 16 (3), pp. 128-140Kass, E.H., Asymptomatic infections of the urinary tract (1956) Trans Assoc Am Phys, 69, pp. 56-64Hoberman, A., Wald, E.R., Reynolds, E.A., Penchansky, L., Charron, M., Pyuria and bacteriuria in urine specimens obtained by catheter from young children with fever (1994) Journal of Pediatrics, 124 (4), pp. 513-519Lapp, M.A., Bridwell, K.H., Lenke, L.G., Baldus, C., Blanke, K., Iffrig, T.M., Prospective randomization of parenteral hyperalimentation for long fusions with spinal deformity: Its effect on complications and recovery from postoperative malnutrition (2001) Spine, 26 (7), pp. 809-817. , DOI 10.1097/00007632-200104010-0002