Surgeon Preference Regarding Wound Dressing Management in Lumbar Fusion Surgery: An AO Spine Global Cross-Sectional Study
Luca Ambrosio,
Gianluca Vadalà,
Javad Tavakoli,
Laura Scaramuzzo,
Giovanni Barbanti Brodano,
Stephen J. Lewis,
So Kato,
Samuel K. Cho,
S. Tim Yoon,
Ho-Joong Kim,
Matthew F. Gary,
Vincenzo Denaro,
Affiliations
Luca Ambrosio
Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
Gianluca Vadalà
Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
Javad Tavakoli
School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, Australia
Laura Scaramuzzo
Spine Surgery Division 1, IRCCS Ospedale Galeazzi-Sant’Ambrogio, Milan, Italy
Giovanni Barbanti Brodano
Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Stephen J. Lewis
UHN-Orthopedics, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada
So Kato
Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
Samuel K. Cho
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
S. Tim Yoon
Department of Orthopaedics, Emory University, Atlanta, GA, USA
Ho-Joong Kim
Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
Matthew F. Gary
Departments of Neurosurgery and Orthopaedic Surgery, Emory University, Atlanta, GA, USA
Vincenzo Denaro
Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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.
