Vacuum-assisted closure for deep infection after spinal instrumentation for scoliosis

• Published in: Journal of bone and joint surgery. British volume Vol. 90; no. 3; pp. 377 - 381
• Main Authors: CANAVESE, F, GUPTA, S, KRAJBICH, J. I, EMARA, K. M
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.03.2008; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Adolescent; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Bone Transplantation; Child; Child, Preschool; Diseases of the osteoarticular system; Diseases of the spine; Female; Follow-Up Studies; Humans; Internal Fixators; Male; Medical sciences; Negative-Pressure Wound Therapy - methods; Neuromuscular Diseases - surgery; Orthopedic surgery; Radiography; Retrospective Studies; Scoliosis - diagnostic imaging; Scoliosis - surgery; Spinal Fusion; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Wound Infection - diagnostic imaging; Surgical Wound Infection - drug therapy; Surgical Wound Infection - therapy; Transplantation, Homologous; Treatment Outcome; Wound Healing; Infection; Deformation; Orthopedic surgery; Treatment; Vacuum; Closure; Spine; Scoliosis; Diseases of the osteoarticular system; Instrumentation; Spine disease
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.90B3.19890

Our aim was to review the efficacy of the wound vacuum-assisted closure (VAC) system in the treatment of deep infection after extensive instrumentation and fusion for spinal deformity in children and adolescents. A total of 14 patients with early deep spinal infection were treated using this technique. Of these, 12 had neuromuscular or syndromic problems. Clinical and laboratory data were reviewed. The mean follow-up was 44 months (24 to 72). All wounds healed. Two patients required plastic surgery to speed up the process. In no patient was the hardware removed and there was no loss of correction or recurrent infection. We believe that the wound VAC system is a useful tool in the armamentarium of the spinal surgeon dealing with patients susceptible to wound infections, especially those with neuromuscular diseases. It allows for the retention of the instrumentation and the maintenance of spinal correction. It is reliable and easy to use.