{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:49Z","timestamp":1787025769490,"version":"build-2736575974"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Postoperative infection remains prevalent after spinal surgical procedures. Institutional protocols for infection prevention have improved rates of infection after spine surgery. However, prior studies have focused on only elective surgical patients. The aim of this study was to determine the efficacy of a multiinstitutional intraoperative sodium oxychlorosene\u2013based infection prevention protocol for decreasing rate of infection after instrumented spinal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective analysis was performed at two tertiary care institutions with level I trauma programs, and patients who underwent posterior instrumented spinal fusion between January 1, 2011, and May 31, 2019, were included. Postoperative deep wound infection rates were captured before and after implementation of a multiinstitutional infection prevention protocol. Possible adverse outcomes related to infection prevention techniques were also examined. In addition, consecutive patients treated from January 1, 2018, to May 31, 2019, were prospectively included in a database to collect preoperative and postoperative spine-specific quality of life measures and to assess the impact of postoperative infection on quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 5047 patients fit the inclusion criteria. Of these, 1043 patients underwent surgery prior to protocol implementation. The infection rate of this cohort (3.5%) decreased significantly after protocol implementation (1.2%, p &lt; 0.001). Postoperative sterile seroma rates did not differ between the preprotocol and postprotocol groups (0.7% vs 0.7%, p = 0.5). In the 1031 patients who underwent surgery between January 2018 and May 2019, the fusion rate was 89.2%. Quality of life outcomes between patients with infection and those without infection were similar, although statistical power was limited owing to the low rate of infection. Notably, 2 of 10 patients who developed deep wound infection died of infection-related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>An intraoperative sodium oxychlorosene\u2013based infection prevention protocol helped to significantly decrease the rate of infection after spine surgery without negatively impacting other postoperative procedure-related metrics. Postoperative wound infection may be associated with higher-than-expected rate of postoperative mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.2.spine202133","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T03:32:51Z","timestamp":1630639971000},"page":"817-823","source":"Crossref","is-referenced-by-count":5,"title":["Use of an intraoperative sodium oxychlorosene\u2013based infection prevention protocol to safely decrease postoperative wound infections after spine surgery"],"prefix":"10.3171","volume":"35","author":[{"given":"Vincent J.","family":"Alentado","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Indiana University, Indianapolis, Indiana;"},{"name":"Indiana University School of Medicine, Indianapolis, Indiana;"},{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Berwanger","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabel M.","family":"Konesco","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex J.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Stockwell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Indiana University, Indianapolis, Indiana;"},{"name":"Indiana University School of Medicine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Dbeibo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"DePowell","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Horn","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad A.","family":"Khairi","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon P.","family":"McCanna","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Mobasser","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel, Indiana;"},{"name":"St. Vincent Health, Indianapolis, Indiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/BRS.0000000000002822","article-title":"Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015","volume":"44","author":"Martin BI","year":"2019","unstructured":"Martin BI, Mirza SK, Spina N,  Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015.Spine (Phila Pa 1976).2019;44(5):369\u2013376.10.1097\/BRS.0000000000002822"},{"issue":"4","key":"b2","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1227\/01.NEU.0000175729.79119.1d","article-title":"National trends in surgical procedures for degenerative cervical spine disease: 1990-2000","volume":"57","author":"Patil PG","year":"2005","unstructured":"Patil PG, Turner DA, Pietrobon R. 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