Antibiotic-loaded bone cement combined with negative pressure wound therapy for treating sacrococcygeal wound following sacral chordoma resection: a case report.

Abstract

Sacral chordoma is a rare, malignant primary bone tumor with subtle clinical manifestations. The extensive cavity and soft tissue defect after radical resection of the tumor can lead to complications such as sacrococcygeal skin necrosis, infection, cerebrospinal fluid (CSF) leakage, and delayed healing or nonhealing. To describe the treatment effect of the combination use of antibiotic-loaded bone cement (ALBC), a gluteus maximus muscle flap, and negative pressure wound therapy (NPWT) on the nonhealing sacrococcygeal wound after sacral chordoma resection. A 67-year-old woman with a sacrococcygeal wound following sacral chordoma resection was admitted to the hospital. In the 2-stage surgery, the internal fixation and synthetic dura substitute were exposed and CSF leakage was found after debridement, a gluteus maximus muscle flap was used to cover the synthetic dura substitute to address the CSF leakage, ALBC was used to cover the internal fixation, and a modified NPWT system was fixed to the wound for improved flushing and drainage. The previously nonhealing wound healed 3 weeks postoperatively, and satisfactory recovery was achieved by 6-month follow-up. This case report suggests that the combination use of ALBC, gluteus maximus muscle flap, and NPWT can effectively promote sacrococcygeal wound healing after chordoma resection.