Strategies of management of deep spinal infection: from irrigation and debridement to vacuum-assisted closure treatment

Abstract

Postoperative surgical site problems (PSSPs) following spinal surgery may lead to patient mortality, increased treatment costs and possible recurrent medical interventions. Despite efforts to reduce spinal surgery-related infection rates, complications are common and significantly increased by patient comorbidities. Since PSSPs occur regardless of deterrent measures, it is essential to distinguish the related risk factors. Different treatment conventions for PSSPs, for example, antibiotic treatment, debridement, soft tissue care and removal of implants have been prescribed with blended outcomes. The utilization of the wound vacuum-assisted closure (VAC) system has gained increasing popularity in the management of deep wound infections after deformity surgery.

Negative pressure wound therapy for surgical site infections: A systematic review and meta‐analysis

“…Treatment of infected wounds typically includes debridement, antibiotics, dressings, continuous irrigation suction systems (CISS), closed suction irrigation system (CSIS) or negative‐pressure wound therapy (NPWT; Daldal & Senkoylu, 2020; Negut et al, 2018; Rayman et al, 2020; Simões et al, 2018). NPWT entered routine clinical practice 40 years ago, primarily for chronic wound treatment (Durandy et al, 1989).…”

Experience in the treatment of implant-associated wound complications after spinal surgery

“…По данным I. Daldal и соавт. (2020), метод использования VAC-повязок последние годы становится одним из наиболее важных инструментов в лечении имплант-ассоциированных раневых осложнений после операций на позвоночнике [19]. VAC-повязка заполняет пустое пространство в ране, очищает ее от экссудата, стимулирует ангиогенез [20].…”

Treating surgical site infection following posterior instrumentation with free-style deepithelialized propeller flap: A case report

“…[12] Complications leading to debridement may result in implant removal and three-dimensional wounds, thereby, increasing the morbidity rates and reducing the patient's quality of life. [13] Managing wounds with dead space, particularly following an infectious condition, still remains problematic. The amount of viable soft tissue after debridement may not be sufficient to fill the dead space and inadequate closure leads to further complications.…”