Risk factors for surgical site infection in pediatric posterior fossa tumors

Childs Nerv Syst. 2021 Oct;37(10):3049-3056. doi: 10.1007/s00381-021-05256-y. Epub 2021 Jun 17.

Abstract

Purpose: Posterior fossa tumors are the most frequent pediatric solid tumor. Its main treatment is a surgical resection. Being a frequent procedure does not mean that it is exempt from complications, such as surgical site infections (SSI). The main objective of this paper is to study the risk factors associated with SSI following a resection of posterior fossa tumors in a purely pediatric population.

Methods: A retrospective case-control study including all posterior fossa tumor surgeries performed at our hospital between January 2014 and December 2019 was conducted. All patients with a diagnosis of a postoperative SSI have been included as cases, and those who had surgery and no infectious complications have been considered as controls.

Results: When analyzing risk factors, we have found that patients with ventriculoperitoneal shunt (VPS) (p = 0.03) or external ventricular drainage (EVD) (p = 0.005) placement had a greater chance of presenting a postoperative surgical site infection. Prolonged operative time (p < 0.001) and cerebrospinal fluid (CSF) leak through the wound (p = 0.002) also caused an increase in the risk of SSI in the postoperative period. A higher hemoglobin value (p = 0.002) would seem to be a preventive factor.

Conclusions: Some strategies that could help to reduce the risk of infections are managing hydrocephalus preferably with endoscopic third ventriculostomy, minimizing the needed operative time to perform the procedure, obtaining an adequate serum hemoglobin level, and avoiding CSF leak through the wound.

Keywords: Infections; Morbidity; Posterior fossa tumor; Postoperative complication; Risk factors.

MeSH terms

  • Case-Control Studies
  • Child
  • Humans
  • Hydrocephalus* / etiology
  • Hydrocephalus* / surgery
  • Infratentorial Neoplasms* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Ventriculostomy