Authors: Koji Yamada, Kazuhiro Kohata

RECOMMENDATION: 1. There is insufficient evidence to recommend for or against normal saline irrigation before closure for the purpose of preventing surgical site infection (SSI) in clean spinal surgery. 2. There is insufficient evidence to support recommendations for optimal volume, type and frequency of irrigation to prevent SSI in clean spinal surgery. 3. Consider the use of irrigation with an aqueous povidone-iodine solution before closure for the purpose of preventing SSI in clean spinal surgery. 4. There is insufficient evidence to recommend for or against chlorhexidine and antibiotic solution irrigation of incisional wounds for the purpose of preventing SSI in clean spinal surgery. 5. There is insufficient evidence to recommend a specific solution (volume, type and frequency) for irrigation in infected spinal surgery.

LEVEL OF EVIDENCE: 1. Consensus 2. Limited 3. Moderate 4. Consensus 5. Consensus

DELEGATE VOTE: Agree: 73%, Disagree: 7%, Abstain: 20% (Super Majority, Strong Consensus)

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