Risk Factors for Postoperative Wound Infections of Sacral Chordoma After Surgical Excision

Study Design: A retrospective study, analyzing the risk factors for postoperative wound infections of the sacral chordoma after surgical excision. Objective: To determine the preoperative, intraoperative, and patient characteristics that contribute to an increased risk of postoperative wound infection in patients undergoing sacral chordoma resection. Summary of Background Data: Postoperative wound infection after spinal operations is a dreaded complication. The risk factors have been investigated earlier, but the patients with sacral chordoma may be distinct. Methods: Between January 1992 and December 2007, 45 patients with sacral chordomas were treated with surgical resection. Data regarding preoperative and intraoperative risk factors for postoperative wound infection were evaluated using univariate analysis and multivariable conditional logistic regression. Odds ratios with 95% confidence intervals and P values were calculated. Results: Of the 45 patients with sacral chordoma, 16 (35.6%) acquired postoperative wound infection. Significant risk factors associated with postoperative wound infection in the univariate analysis included the following: albumin < 3.0, previous surgery, operating time, instrumentation, and surgical team. Albumin < 3.0, operating time > 6 hours, and previous surgery were statistically significant in the multivariable model. Conclusions: Patients undergoing sacral tumor surgery may be at greater risk for developing wound complications. In this study, it seems that albumin < 3.0, operating time > 6 hours, and previous surgery may predict those patients that were more prone to developing postoperative wound infection. Using a single surgical team and no instrumentation seems to provide protection against postoperative wound infection in this patient population.