Patient selection: status post pediatric scoliosis surgery
Incidence of deep SSI: 6%
Symptoms: back pain, wound drainage
Parameters:
(1) type of scoliosis
(2) volume of instrumentation required
(3) use of allograft bone
|
Parameter
|
Finding
|
Points
|
|
type of scoliosis
|
idiopathic
|
0
|
|
|
secondary (nonidiopathic)
|
1
|
|
instrumentation volume
|
lower volume
|
0
|
|
|
higher volume
|
1
|
|
allograft bone
|
not used
|
0
|
|
|
used
|
1
|
where:
• Secondary causes included thoracic insufficiency syndrome, congenital, neuromuscular disease, and kyphosis.
• Patients with scoliosis due to a neuromuscular disorder were at greater risk for deep SSI compared to other diagnoses/
total number of risk factors =
= SUM(points for all 3 factors)
Interpretation:
• minimum number: 0
• maximum number: 3
• The higher the number of risk factors the greater the risk of a deep SSI.
The authors recommended a number of steps to be taken to reduce the risk of deep SSI (see next). Failure to adhere to preventive measures would be an additional risk factor for SSI.
