Postoperative neurosurgical infection rates after shared-resource intraoperative magnetic resonance imaging - a single center experience with 195 cases.

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Postoperative neurosurgical infection rates after shared-resource intraoperative magnetic resonance imaging - a single center experience with 195 cases.

World Neurosurg. 2017 Mar 28;:

Authors: Dinevski N, Sarnthein J, Vasella F, Fierstra J, Pangalu A, Holzmann D, Regli L, Bozinov O

Abstract
OBJECTIVE: To determine the rate of surgical site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database METHODS: All consecutive neurosurgical procedures that were performed with a high-field, two-room ioMRI between April 2013 and June 2016 were included (N=195; 109 craniotomies and 86 endoscopic transsphenoidal procedures). The incidence of surgical site infections (SSI) within three months after surgery was assessed for both operative groups (craniotomies versus transsphenoidal approach).
RESULTS: Of the 109 craniotomies, six patients developed an SSI (5.5%, 95%-Confidence interval [CI]: 1.2%, 9.8%), including one superficial SSI, two cases of bone flap osteitis, one intracranial abscess and two cases of meningitis/ventriculitis. Wound revision surgery due to infection was necessary in four patients (4%). Of the 86 transsphenoidal skull base surgeries, six patients (7.0%, 95%-CI: 1.5%, 12.4%) developed an infection, including two non-CNS intranasal SSIs (3%) and four cases of meningitis (5%). Logistic regression analysis revealed that the likelihood of infection significantly decreased with the number of operations in the new operational setting (odds ratio: 0.982, 95%-CI: 0.969-0.995, p=0.008).
CONCLUSIONS: The use of a shared-resource ioMRI in neurosurgery did not demonstrate elevated infection rates as compared to the current available literature. The likelihood of infection decreased with the accumulating number of operations, underlining the importance of surgical staff training after the introduction of a shared-resource ioMRI.

PMID: 28363833 [PubMed - as supplied by publisher]

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