Does Plastic Incise Drape Prevent Recolonization of Endogenous Skin Flora during Lumbar Spine Procedures

Background and Objective: Surgical Site Infection (SSI) is a common problem after spinal surgery that increase the cost of surgical care, morbidity and mortality. The majority of SSIs result from the patient’s endogenous flora that originates primarily from the patients skin. The aim of this study was to compare the plastic incise drape (PID) with without plastic incise drape (bare skin) regarding bacterial recolonization and bacterial re-growth of the adjacent skin of surgical incision, in lumbar spine surgery patients.Materials and Methods: This quasi‑experimental study with nonequivalent control group design was conducted from February to May 2018 on 88 patients who were candidate for lumbar spine surgery. Patients were assigned to one of two groups: treatment (with PID) and control (without PID). Skin sampling (adjacent of surgical incision) for bacterial culture was done in two steps, immediately after surgical skin prep (IASSP) and immediately after surgical wound closure (IASWC) by researcher. Finally, samples were sent to the laboratory.Findings: The mean total bacterial count of patient’s skin in stage IASSP was not significantly different between treatment and control groups (0.34 vs. 0.27, P = 0.68). However, mean total bacterial count in stage IPSWC in treatment group was significantly higher than control group (2.2 vs. 0.93, P = 0.03). The frequency distribution of S. aureus (P = 0.04) and S. epidermidis (P = 0.02) was significantly higher in treatment group compared with control group in stage IASWC.Conclusion: The results showed that using PID is unable to reduce recolonization and re-growth of bacteria on patients skin adjacent to surgical wound in clean lumbar spine surgeries. However, making a definite decision about using or not using of PID requires further studies

Keywords:

lumbar vertebrae , surgical drapes , Bacteria , Surgical Wound