الفهرس 
Surgical site infections in spine surgeriesOnly 14 pages are availabe for public view
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Abstract
Wound suction drains have been used to decrease the rate of postoperative hematoma formation and thus wound infections for many years throughout all surgical subspecialties. Although the use of surgical drains dates back to the years of Hippocrates, in the orthopedic literature these drains have not been shown to be beneficial in decreasing the rates of these complications, especially in orthopedic procedures including fracture fixation or arthroplasty surgeries. However, these drains are still commonly used throughout the orthopedic community, including spine surgery. Debate in this area remains, as proponents of its use in the immediate postoperative period believe that it will prevent fluid collection in the surgical dead space, and thus eliminates the media for bacterial growth. On the other hand, opponents believe that they are considered a foreign body that promotes inflammation and even sometimes provokes an infectious response. In spine surgery, the controversy is even more profound because it decreases the rare but devastating complication of postoperative epidural hematoma, but it may have a hypothetical increase in the risk of infection(1).
Subfacial drains are routinely used after multi-level anterior cervical discectomy and fusion (ACDF) procedures. The use of these kinds of drains following multi-level ACDFs is motivated by a desire to reduce postoperative complications such as surgical site infections (SSIs) and the development of life-threatening hematomas that may cause airway obstruction(5).
Most degenerative spine diseases comprise extradural lesions and, in such cases, hematoma/fluid collection or infection are the main points of interest with regard to wound drainage. For intra-dural spine disease, leakage or collection of cerebrospinal fluid (CSF) through closed dura or the surgical wound is an additional point of interest. However, there are no reports that have determined the necessity of using closed-suction drainage after intra-dural spine surgery. Closed-suction drainage may be beneficial in reducing CSF collection, but such drainage may promote continuous leakage of CSF through closed dura or the surgical wound(7).