Preventing and treating surgical site infection in patients with spinal metastatic disease

Surgery to remove secondary spinal tumours is often necessary to relieve symptoms associated with metastatic spinal cord compression (MSCC). However, such individuals are at high risk of surgical site infection (SSI). This article aims to summarise published literature reporting interventions used to prevent or treat SSI in people with MSCC. A systematic review of the literature was undertaken with randomised controlled trials (RCTs) and non-RCTs of any intervention to prevent or treat SSI eligible for inclusion if a MSCC patient group was reported. Seven reports were included, of which only one was an RCT. Preventative interventions included intraoperative wound irrigation with dilute povidone-iodine solution, postoperative prostaglandin E1 administration, use of a specific intraoperative antibiotic regimen, and soft-tissue reconstruction strategies following surgery. Methods to treat SSI involved the use of soft-tissue reconstructive strategies. Several methods to prevent and treat SSI in MSCC patients are highlighted. However, further high-level research is needed to determine the efficacy of such interventions.