Neurospine.
2024 Mar;21(1):204-211. 10.14245/ns.2347168.584.
Surgeon Preference Regarding Wound Dressing Management in Lumbar Fusion Surgery: An AO Spine Global Cross-Sectional Study
- Ambrosio L
1,2 - Vadalà G1,2
- Tavakoli J3
- Scaramuzzo L4
- Brodano GB5
- Lewis SJ6
- Kato S7
- Cho SK8
- Yoon ST9
- Kim HJ10
- Gary MF11
- Denaro V1
- AO Spine Knowledge Forum Degenerative1
- Affiliations
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- 1Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- 2Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
- 3School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, Australia
- 4Spine Surgery Division 1, IRCCS Ospedale Galeazzi-Sant’Ambrogio, Milan, Italy
- 5Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- 6UHN-Orthopedics, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada
- 7Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
- 8Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- 9Department of Orthopaedics, Emory University, Atlanta, GA, USA
- 10Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- 11Departments of Neurosurgery and Orthopaedic Surgery, Emory University, Atlanta, GA, USA
- KMID: 2553921
- DOI: http://doi.org/10.14245/ns.2347168.584
Abstract
Objective
To evaluate the global practice pattern of wound dressing use after lumbar fusion for degenerative conditions.
Methods
A survey issued by AO Spine Knowledge Forums Deformity and Degenerative was sent out to AO Spine members. The type of postoperative dressing employed, timing of initial dressing removal, and type of subsequent dressing applied were investigated. Differences in the type of surgery and regional distribution of surgeons’ preferences were analyzed.
Results
Right following surgery, 60.6% utilized a dry dressing, 23.2% a plastic occlusive dressing, 5.7% glue, 6% a combination of glue and polyester mesh, 2.6% a wound vacuum, and 1.2% other dressings. The initial dressing was removed on postoperative day 1 (11.6%), 2 (39.2%), 3 (20.3%), 4 (1.7%), 5 (4.3%), 6 (0.4%), 7 or later (12.5%), or depending on drain removal (9.9%). Following initial dressing removal, 75.9% applied a dry dressing, 17.7% a plastic occlusive dressing, and 1.3% glue, while 12.1% used no dressing. The use of no additional coverage after initial dressing removal was significantly associated with a later dressing change (p < 0.001). Significant differences emerged after comparing dressing management among different AO Spine regions (p < 0.001).
Conclusion
Most spine surgeons utilized a dry or plastic occlusive dressing initially applied after surgery. The first dressing was more frequently changed during the first 3 postoperative days and replaced with the same type of dressing. While dressing policies tended not to vary according to the type of surgery, regional differences suggest that actual practice may be based on personal experience rather than available evidence.
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