The infection of the surgical site following a neurosurgery operation is one of the most complex complications facing specialized surgical nursing, due to its potential danger for the appropriate recovery of the patients. CEU-Vithas Nisa Neuroscience Chair researcher María Pilar Chisbert Genovés has studied the risk factors of these infections in her doctoral thesis, under the guidance of neurosurgeon, UCH CEU University professor and Chair head José Piquer Belloch. The results of her research show that the probability of infection is around 1% in this type of surgeries and that risk factors are more related to the patient's condition and history rather than the operation itself.
The study has analyzed craniotomies and spine surgeries conducted throughout a decade, in order to study the cases where an infection of the surgical site took place. This analysis has enabled the establishment of 32 risk factors for cranial surgery and 41 for spine surgery. Variables such as the infection detection time, the existence of infectious entrenchment, its microbiology, the antibiotic treatment provided, the necessary surgical measures and the final evolution of the patient have also been studied, among others.
Low risk of infection
As researcher María Pilar Chisbert explains, "in the over three thousand cases studied, there were infections in just 1.6% of craniotomies and 0.87% of spine surgeries, which shows that the risk is very low for this type of surgeries." Of the 870 craniotomies conducted on 710 patients, only 14 had an infection of the surgical site. And of the 2,301 spine surgeries on 2,090 patients, there was an infection in just 20 cases.
However, in the case of death due to the infection sustained, the study has detected two relevant risk factors: obesity and the coexistence of other infections. "In the cranial surgery cases studied - adds doctor Chisbert -, suffering obesity doubles the death rate, and suffering other infections multiplies the risk by four. Regarding spine surgery, both factors double the death rate."
Patient condition and risks
For the author of the thesis, "these results lead us to conclude that the risk factors of infections to the surgical site in operations in the field of neurosurgery are more related to the patient's condition rather than the operation itself." Thus, the main recommendation for neurosurgical nurses is to "increase the monitoring of the perioperative process of patients who suffer from obesity or other infections and provide specific care to prevent a possible infectious complication related to the surgical wound."
The thesis of María Pilar Chisbert, entitled "Infección del sitio quirúrgico en cirugía craneal y raquimedular: estudio comparativo de los factores de riesgo", has been guided by doctor José Piquer Belloch. This thesis was the first of the Nursing speciality of the CEINDO Doctorate School to be submitted at the CEU UCH, and it was awarded the highest possible marks by the examining board.
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