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Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery.

Publication ,  Journal Article
Mehta, AI; Babu, R; Sharma, R; Karikari, IO; Grunch, BH; Owens, TR; Agarwal, VJ; Sampson, JH; Lad, SP; Friedman, AH; Kuchibhatla, M ...
Published in: J Bone Joint Surg Am
February 20, 2013

BACKGROUND: Surgical site infections increase the incidence of morbidity and mortality as well as health-care expenses. The cost of care increases threefold to fourfold as a consequence of surgical site infection after spinal surgery. The aim of the present study was to determine the role of subcutaneous fat thickness in the development of surgical site infection following cervical spine fusion surgery. METHODS: We performed a retrospective review of a consecutive cohort of 213 adult patients who underwent posterior cervical spine fusion between 2006 and 2008 at Duke University Medical Center. The horizontal distance from the lamina to the skin surface at the C5 level and the thickness of subcutaneous fat were measured, and the ratio of the fat thickness to the total distance at the surgical site was determined. Previously identified risk factors for the development of surgical site infection were also recorded. RESULTS: Twenty-two of the 213 patients developed a postoperative infection. Obesity (body mass index ≥ 30 kg/m2) was not a significant risk factor for surgical site infection; the body mass index (and 95% confidence interval) was 29.4 ± 1.2 kg/m2 in the patients who developed a surgical site infection compared with 28.9 ± 0.94 kg/m2 in the patients without an infection. However, the thickness of subcutaneous fat and the ratio of the fat thickness to the lamina-to-skin distance were both significant risk factors for infection. The thickness of subcutaneous fat was 27.0 ± 2.5 mm in the patients who developed a surgical site infection group compared with 21.4 ± 0.88 mm in the patients without an infection (p = 0.042). The ratio of fat thickness to total thickness was 0.42 ± 0.019 in the patients who developed a surgical site infection compared with 0.35 ± 0.01 in the patients without an infection (p = 0.020). Multivariate analysis revealed this ratio to be an independent risk factor for developing a postoperative infection (odds ratio, 3.18; 95% confidence interval, 1.02 to 9.97). CONCLUSIONS: The study demonstrated that the thickness of subcutaneous fat at the surgical site is a factor in the development of surgical site infection following cervical spine fusion and deserves assessment in the preoperative evaluation.

Duke Scholars

Published In

J Bone Joint Surg Am

DOI

EISSN

1535-1386

Publication Date

February 20, 2013

Volume

95

Issue

4

Start / End Page

323 / 328

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Surgical Wound Infection
  • Subcutaneous Fat
  • Spinal Fusion
  • Risk Factors
  • Retrospective Studies
  • Prevalence
  • Orthopedics
  • North Carolina
  • Middle Aged
 

Citation

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Mehta, A. I., Babu, R., Sharma, R., Karikari, I. O., Grunch, B. H., Owens, T. R., … Gottfried, O. N. (2013). Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery. J Bone Joint Surg Am, 95(4), 323–328. https://doi.org/10.2106/JBJS.L.00225
Mehta, Ankit I., Ranjith Babu, Richa Sharma, Isaac O. Karikari, Betsy H. Grunch, Timothy R. Owens, Vijay J. Agarwal, et al. “Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery.J Bone Joint Surg Am 95, no. 4 (February 20, 2013): 323–28. https://doi.org/10.2106/JBJS.L.00225.
Mehta AI, Babu R, Sharma R, Karikari IO, Grunch BH, Owens TR, et al. Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery. J Bone Joint Surg Am. 2013 Feb 20;95(4):323–8.
Mehta, Ankit I., et al. “Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery.J Bone Joint Surg Am, vol. 95, no. 4, Feb. 2013, pp. 323–28. Pubmed, doi:10.2106/JBJS.L.00225.
Mehta AI, Babu R, Sharma R, Karikari IO, Grunch BH, Owens TR, Agarwal VJ, Sampson JH, Lad SP, Friedman AH, Kuchibhatla M, Bagley CA, Gottfried ON. Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery. J Bone Joint Surg Am. 2013 Feb 20;95(4):323–328.

Published In

J Bone Joint Surg Am

DOI

EISSN

1535-1386

Publication Date

February 20, 2013

Volume

95

Issue

4

Start / End Page

323 / 328

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Surgical Wound Infection
  • Subcutaneous Fat
  • Spinal Fusion
  • Risk Factors
  • Retrospective Studies
  • Prevalence
  • Orthopedics
  • North Carolina
  • Middle Aged