Outcomes of Negative Pressure Wound Therapies in the Management of Spine Surgical Site Wound Infections.

Autor:	Kurra S; Department of Orthopaedic Surgery, SUNY Upstate Medical University, Syracuse, New York., Rashid A; Department of Orthopaedic Surgery, SUNY Upstate Medical University, Syracuse, New York., Yirenkyi H; Department of Orthopaedic Surgery, SUNY Upstate Medical University, Syracuse, New York.; OrthoAtlanta and Sports Medicine Specialists, Stockbridge, Georgia., Castle P; Department of Orthopaedic Surgery, SUNY Upstate Medical University, Syracuse, New York., Lavelle WF; Department of Orthopaedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2020 Oct; Vol. 14 (5), pp. 772-777. Date of Electronic Publication: 2020 Oct 12.
DOI:	10.14444/7110
Abstrakt:	Background: Many studies report benefits using negative pressure wound therapy (NPWT) in surgical site infections (SSIs). We measured and compared efficacy and complications associated with NPWT for traditional versus suprafascial vacuum-assisted closures (VACs). Methods: This is a retrospective chart review of consecutive SSIs managed with negative wound therapy after spinal procedures between 2012 and 2015 from a single, academic center. Patients were collected through International Classification of Diseases, Ninth Revision, procedure codes. Inclusion criteria were patients with spine SSIs managed by irrigation and debridement with a VAC device; infection occurring after spinal surgeries; and age over 18. A total of 23 consecutive patients met the criteria. We reviewed demographic data, surgical data, infectious disease data, discharge summaries, and postoperative follow-up charts. We compared and analyzed demographics, duration of VAC therapy, and reoperation rates between VAC groups. Statistical analysis was completed using analysis of variance and χ 2 tests; P ≤ 0.05 was considered statistically significant. Results: A total of 7 patients had traditional VACs (Group 1), and 16 patients had suprafascial VACs (Group 2). Average blood loss and number of levels involved during index surgery were not statistically significant between groups. Locations of infection occurrence were cervical spine = 3, thoracic spine = 1, and lumbar spine = 19. Reoperation rate after initial wound VAC placement was 34%, with rates significantly higher for Group 1 (71%) than Group 2 (16%), P = 0.02. Average duration of wound therapy was longer in Group 1 (77 days) than Group 2 (33 days), P = 0.08. Average number of operating room visits after initial wound VAC implantation were 0.7 for Group 1 and 0.3 for Group 2, P = 0.26, before obtaining a clean wound closure. Conclusions: Small sample size and retrospective nature were limitations. Negative pressure wound therapy may be useful for managing spinal infections, and suprafascial VAC had less time duration, lower risk of sponge fragment retainment, and fewer procedures to ultimately achieve wound closure. Level of Evidence: 3. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2020 ISASS.)
Databáze:	MEDLINE
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