Abstract
BackgroundWound infections after posterior spinal surgery are a troublesome complication; patients are occasionally forced to remove the internal fixation device, which can lead to instability of the spine and injury to the spinal cord. The purpose of this study was to evaluate the efficacy of modified vacuum-assisted closure (VAC) for treating an early postoperative spinal wound infection.MethodsWe conducted a retrospective study of 18 patients with wound infections after posterior spinal surgery from 2014 to 2017 at a single tertiary center. All patients included in the study received modified VAC treatment (VAC combined with a closed suction irrigation system, CSIS) until the wound satisfied the secondary closure conditions. Detailed information was obtained from the medical records.ResultsWound size decreased significantly after 1 week of the modified VAC treatment. Three patients were treated with VAC three times and one patient received the VAC treatment four times; the remaining patients received the VAC treatment twice. The patients had excellent wound beds after an average of 8 days. The wound healed completely after an average of 17 days, and the average hospital stay was 33 days. There was no recurrence of infection at the 1-year follow-up.ConclusionsThis study demonstrates that VAC combined with a CSIS is a safe, reliable, and effective method to treat a wound infection after spinal surgery. This improved VAC procedure provides an excellent wound bed to facilitate wound healing and shorten the hospital stay.
Highlights
Wound infections after posterior spinal surgery are a troublesome complication; patients are occasionally forced to remove the internal fixation device, which can lead to instability of the spine and injury to the spinal cord
We retrospectively evaluated the efficacy of a modified vacuum-assisted closure (VAC) device (VAC combined with closed suction irrigation system (CSIS)) to treat wound infections after spinal surgery
Three patients were treated with VAC three times and one patient received VAC treatment four times, while the remainder received two VAC treatments
Summary
Wound infections after posterior spinal surgery are a troublesome complication; patients are occasionally forced to remove the internal fixation device, which can lead to instability of the spine and injury to the spinal cord. The purpose of this study was to evaluate the efficacy of modified vacuum-assisted closure (VAC) for treating an early postoperative spinal wound infection. Traditional dressings have been used on surgical site infections for many years, but these tend to make patients extremely uncomfortable due to pain, foul smell, high cost, and prolonged hospital stay. These conditions have led to the development of a convenient, effective, and economic wound care method in which negative pressure is exerted on the wound after debridement. Recent studies have shown that negative pressure wound therapy is a safe and effective technique in the treatment of wound infection after spinal surgery, and excellent clinical results have been obtained. A retrospective study of 30 cases has demonstrated that negative pressure wound therapy was safe in the treatment of wound infection after spinal internal fixation even with exposed dura [11]
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