Article
The use of topical negative pressure therapy in deep wound infection after spinal surgery
Die Anwendung einer vakuumunterstützten Wundbehandlung bei tiefen Infektionen nach Wirbelsäuleneingriffen
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Published: | May 8, 2006 |
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Objective: Postoperative infections remain a challenge after spinal surgery. Most infected back wounds are treated with drainage, debridement, antibiotics and delayed closure. For infected or chronic wounds, topical negative pressure therapy can act as an intermediate phase in wound closure. Our clinical experience of topical negative pressure therapy to close infected wounds after spinal surgery is presented.
Methods: In our clinic 13 patients with open infected wounds after spinal surgery (without dura opening), were successfully treated by topical negative pressure therapy and intermittend debridement between 2003 and 2005. There were 7 patients with deep wound infection after lumbar, 1 after thoracal and 5 after cervical neurosurgical spinal surgery. The wounds were closed by secondary sutures.
Results: There were 7 men and 6 women with an average age of 61 years (34-77). Once the topical negative pressure therapy was initiate, there was an average of 3,8 procedures until and including closure of the wound. Within in average11 days (7-16) the infected wounds had been under control and were closed. All patients were kept under additional systemic antibiotic therapy. All Patients achieved a clean closed wound and tolerated topical negative pressure therapy without adverse effects. The average follow up was 13 months (1-26 months) with no sign of infection recurrence or new neurological deficit.
Conclusions: Topical negative pressure therapy seems to be beneficial in complicated infected wounds with impaired wound healing after neurosurcical spinal surgery. The use of this technique can be an efficacious alternative modality to prepare infected or non healing wounds in a short period of time for defect coverage.