A review of some 110 cases of spine surgeries done between September 2014 and December last year in Nigeria found “very little incidence” of wound infection, the Brain and Spine Surgery Consortium say.
Surgery sites are considered to have wound infections when there is pus to be drained from the site and a culture is positive for bacteria within 30 days of the operation.
“This should be of comfort to patients requiring surgical intervention for spine diseases in Nigeria,” said Dr Biodun Ogungbo, neurosurgeon with Spine Fixed in Abuja.
“The operations are being performed successfully in Abuja, Lagos and other places with good postoperative care and recovery. This achievement will help to reinforce confidence in the local practice and hopefully will help in reducing medical tourism for spine cases.”
He said keeping away wound infections after surgery was possible by removing wound drains and urinary catheters as a routine 48 hours after the surgery.
The only exception was in patients with spinal injuries whose management require them to constantly use a catheter for urinating.
“One other important aspect of our nursing care is that the wounds are not opened and cleaned daily as done in some centres. Wounds are only opened if the dressing was dirt,” he said.
“Even then, there is usually no specific cleaning of the suture site itself unless clearly indicated. More often than not, the dressing is simply changed and the wound left undisturbed.”
Delayed healing of wound was observed in diabetic and obese patients, but they did not contribute to injuries and cause death, he said.
Injuries came from operations that required to be redone: for misplaced screws in three patients; repeated disc prolapsed in another patient; and two other patients needed second-look surgeries for continuing leg pains.
None led to infections. But two patients died in the case series reviewed, both elderly patients with simultaneous different conditions.
Ogungbo said because of the deaths recorded, elderly patients and those with significant morbidity are now closely monitored in a high dependency unit for as long as required to prevent further deaths in their patient population.
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