Treatment of Postoperative Wound Infections Following Spinal Fusion with Instrumentation

Abbey, David M.; Turner, Donn M.; Warson, James S.; Wirt, Timothy C.; Scalley, Robert D.

doi:10.1097/00002517-199508040-00003

Cited by 167 publications

(105 citation statements)

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“…Debridement without removal of the implant combined with prolonged intravenous antibiotic treatment and subsequent long-term oral antibiotic therapy has a failure rate between 32 and 86% [71]. Others, on the other hand, prefer removal of the instruments to eradicate the infection that followed the instrumented spinal fusion [1,4,13,55,56,62]. Another possibility is instrumentation removal in case of late deep infection, debridement and new reinstrumentation to achieve permanent correction for scoliosis [50].…”

Section: Discussionmentioning

confidence: 99%

Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

et al. 2006

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The use of vacuum assisted closure (V.A.C.) therapy in postoperative infections after dorsal spinal surgery was studied retrospectively. Successful treatment was defined as a stable healed wound that showed no signs of acute or chronic infection. The treatment of the infected back wounds consisted of repeated debridement, irrigation and open wound treatment with temporary closure by V.A.C. The instrumentation was exchanged or removed if necessary. Fifteen patients with deep subfascial infections after posterior spinal surgery were treated. The implants were exchanged in seven cases, removed completely in five cases and left without changing in one case. In two cases spinal surgery consisted of laminectomy without instrumentation. In two cases only the wound defects were closed by muscle flap, the remaining ones were closed by delayed suturing. Antibiotic treatment was necessary in all cases. Follow up was possible in 14 patients. One patient showed a new infection after treatment. The study illustrates the usefulness of V.A.C. therapy as a new alternative management for wound conditioning of complex back wounds after deep subfascial infection.

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Section: Discussionmentioning

confidence: 99%

Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

et al. 2006

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“…Of the many possible complications, a postoperative infection is potentially devastating. The reported rates of a postoperative wound infection for a spinal fusion with instrumentation range from 2.6% to 10% [1,3,9,13,15,17]. The increased infection rates are likely to be due to procedures that increase surgical time, blood loss, and tissue damage [2,10].…”

Section: Discussionmentioning

confidence: 99%

“…In the management of a postoperative deep wound infection after instrumentation, implant removal is not recommended, particularly in early active infection [1,9,10,15,17]. The first choice to eradicate the infection would be a debridement and irrigation only, while maintaining implants and using antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…A wide debridement and irrigation-suction system should first be attempted to eradicate the infection [1,7,9,10,13,17,20]. However, in the case of an uncontrolled, persistent postoperative infection, especially one associated with a PLIF using cages, a different approach is needed.…”

Section: Kee-yong Ha Young-hoon Kimmentioning

confidence: 99%

“…The increased infection rates are likely to be the result of procedure-related increases in operative time, blood loss, and tissue damage [1,2,6,9,17]. In order to manage a postoperative infection of an instrumented spine, most surgeons agree that removal of implants might be unnecessary, particularly in the early stages of a postoperative Abstract The recommended surgical options for postoperative wound infections after instrumented spine surgery include a wide debridement and irrigation with antibiotics.…”

Section: Introductionmentioning

confidence: 99%

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