PURPOSE: The incidence of surgical site infections is considered a relevant indicator of perioperative and postoperative care quality. The aim of this study is to analyze and evaluate SSIs after elective cervical spine surgery under the guidance of our preventive multimodal wound protocol. METHODS: A monocentric observational cohort study analyzed 797 patients who underwent cervical spine surgery from 2005 to 2010 (mean age 51.58 ± 11.74 year, male 56.09%, mean BMI 26.87 ± 4.41, ASA score 1-2 in 81.68% of patients), fulfilling the entry criteria: (1) cervical spine surgery performed by neurosurgeons (degenerative disease 85.19%, trauma 11.04%, tumor 3.76%), (2) elective surgery, (3) postoperative care in our neurointensive care unit. Our preventive wound control protocol management focused mainly on antibiotic prophylaxis, wound hygiene regime, and drainage equipment. All wound complications and surgical site infections were monitored up for 1 year after surgery. RESULTS: We had only 2 (0.25%) patients with SSI after cervical spine surgery-one organ/space infection (osteomyelitis, primary due to liquorrhea) after anterior surgical approach, and one deep surgical site infection (due to dehiscence) after posterior approach. We had 17 (2.13%) patients with some wound complications (secretion 7, dehiscence 4, hematoma 1, edema 3, and liquorrhea 2) that were not classified as SSI according to the CDC guidelines. CONCLUSION: Concerning our study population of patients undergoing elective cervical surgery, with ASA scores 1-2 in 81.68% of our patients, the incidence of SSI was 0.14% after anterior surgical approach, 1.4% after posterior surgical approach, and 0.25% altogether in the referred cohort.

Department of Anaesthesia and Intensive Care 3 Medical Faculty Charles University Srobarova 50 100 34 Prague Czech Republic

Department of Clinical Pharmacology Na Homolce Hospital Roentgenova 37 2 150 30 Prague 5 Czech Republic

Department of Neurosurgery 2nd Faculty of Medicine Charles University Prague and Motol University Hospital 5 Úvalu 84 1 150 06 Prague Czech Republic

Faculty of Health Studies Technical University of Liberec Studentská 1402 2 461 17 Liberec 1 Czech Republic

Institute of Physiology 1st Medical Faculty Charles University Prague Albertov 5 12800 Prague 2 Czech Republic

Neurocenter Department of Neurosurgery Regional Hospital Husova 357 10 46063 Liberec Czech Republic

Neurocenter Neurointensive Care Unit Regional Hospital Husova 357 10 46063 Liberec Czech Republic

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