Nigerian surgeons under the aegis of the Brain and Spine Surgery Consortium, upped their ante in 2016, as they performed safe spine operations, recording very little incidence of wound infection in the country.
A statement made available to LEADERSHIP by Dr Biodun Ogungbo of the Spine Fixed in Abuja (SFIA) clinic, said a retrospective review of consecutive cases of patients who underwent spine operations at the clinic in Abuja, recorded zero case of deep seated wound infection in 110 cases. According to him, the study looked at cases from September 2014 to December 2016 to evaluate the rate of wound infection in their spine patients.
Wound infection is defined as the presence of or drainage of pus from the operative site and a positive bacteriological culture within 30 days of the operation.
Ogungbo revealed that many aspects of their practice ensured this remarkable result. Part of their practice was that wound drains and urinary catheters are removed routinely on day two after operations except in patients with spinal injuries who require urine catheterization for patient management.
“One other important aspect of our nursing care is that the wounds are not opened and cleaned daily as done in some centres. Wounds are only opened if the dressing was dirty. Even then, there is usually no specific cleaning of the suture site itself unless clearly indicated. More often than not, the dressing is simply changed and the wound left undisturbed.”
Ogungbo, who is a neuro surgeon explained, “There were cases with wound dehiscence and delayed wound healing especially in obese patients and Diabetics but these did not add to morbidity or lead to mortality in our patients.”
He said such wound problems were managed adequately by re-suturing or a pedicle flap by the plastic surgeon without any involvement of the deeper tissues in patients with surgical implants, which, however, led to delay in hospital discharge and added to overall cost of care.
“Morbidity in our series related to redo operations for misplaced screws (three patients), recurrent disc prolapse (1 patient) and second look surgeries for continuing leg pains (two patients). The repeat operations did not lead to infections.
“Two patients died in this case series: one, two days after simple lumbar decompression following failure of his pacemaker and the other from respiratory failure following instrumented lumbar fusion. Both were elderly patients with significant co-morbidities. “
He added that because of the deaths recorded, elderly patients and those with significant morbidity are now closely monitored in a high dependency unit for as long as required to prevent further deaths in their patient population.
Ogungbo said, “This should be of comfort to patients requiring surgical intervention for spine diseases in Nigeria. The operations are being performed successfully in Abuja, Lagos and other places with good postoperative care and recovery. This achievement will help to reinforce confidence in the local practice and hopefully will help in reducing medical tourism for spine cases.”
By: Winifred Ogbebo, Abuja
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