• Moses Osaodion Inojie, Okwuoma Okwunodulu, Chika Anele Ndubuisi, Francis Chukwuebuka Campbell, and Samuel Chwukwunoyerem Ohaegbulam.
• Memfys Hospital for Neurosurgery, Enugu, Enugu State, Nigeria; Federal Medical Centre, Asaba, Delta State, Nigeria. Electronic address: mosege2000@yahoo.com.
• World Neurosurg. 2023 May 1; 173: e1e10e1-e10.

BackgroundIntraoperative wound irrigation (IOWI) is an important step in preventing surgical site infection (SSI). This study compared the effectiveness of saline with gentamicin versus povidine-iodine (PI) as IOWI solutions in preventing SSI in open spine surgery.MethodsIt is a prospective comparative study. Patients who had noninstrumented open spine surgery were randomized into 2 groups. Group A and B patients had their surgical wounds irrigated with saline containing gentamicin solution and dilute PI solution, respectively. Both groups were assessed for the occurrence of SSI.ResultsA total of 80 patients, divided into 2 groups of 40 each completed the study. Overall, the SSI rate was 17.5% for patients in the normal saline containing gentamicin group (A) and 2.5% for those in the dilute PI group (B), this difference was statistically significant (P = 0.025). The cervical and thoracic spine regions have the same SSI rate (7.1% and 0%, respectively) in both groups. However, in the lumbosacral region, the SSI rate was 31.6% in A and 0% in B, this was statistically significant (P = 0.006). The isolated organisms in patients with SSI were staphylococcus species (42.86% of SSI in A and 0% in B) and pseudomonas species (42.86% of SSI in group A and 100% in group B), and this difference was profound in the lumbosacral spine region (P = 0.008).ConclusionsIOWI with 3.5% dilute PI solution is more efficacious in preventing SSI and has wider microbial coverage compared to normal saline containing gentamicin solution as IOWI fluid in noninstrumented open spine surgery.Copyright © 2023 Elsevier Inc. All rights reserved.

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