10. USE OF VACUUM ASSISTED CLOSURE THERAPY IN MANAGEMENT OF INFECTION POST SCOLIOSIS SURGERY

Vo Quang Dinh Nam1
1 Hospital for Traumatology and Orthopaedics

Main Article Content

Abstract

Background: Infection after spine surgery is a very serious problem, patients may have to stay in hospital for a long time, increase costs, and sometimes forced to remove internal fixation devices, which significantly affects the outcome. Till date, many treatment protocols have been recommended include debridement, antibiotic, soft-tissue management, but with mixed results. The use of vacuum assisted closure has been gaining popularity recently, in the management of subacute, acute, and chronic wounds.


Objective: To evaluate the initial results of using the vacuum assisted closure system in the management of infection after scoliosis surgery.


Method: Conduct a retrospective study on 3 patients with infection after scoliosis correction surgery from January 2022 to April 2024. All patients were treated with VAC irrigation (vacuum assisted closure combined with closed suction irrigation system) until the wound satisfies the conditions for secondary wound closure.


Results: 2 patients were treated with vacuum assisted closure two times and 1 patient received the vacuum assisted closure treatment one time. All patients had excellent wound beds and secondary wound closure after an average of 12.3 days. No need to remove instruments. The average hospital stay was 29.3 days. There were no recurrences of infection and no loss of correction of the spinal deformity during the follow-up period.


Conclusion: Small sample size and retrospective nature were limitations. This study shows the advantages of using vacuum assisted closure in patients with infections post scoliosis surgery. It helps heal wounds, prevent prolonged illness as well as remove instruments that affect the results of correction.

Article Details

References

[1] Sponseller P.D, LaPorte D.M, Hungerford M.W et al. Deep wound infections after neuromuscular scoliosis surgery: A multicenter study of risk factors and treatment outcomes. Spine (Phila Pa 1976), 2000, 25 (19): 2461-2466.
[2] Argenta L.C, Morykwas M.J. Vacuum assisted wound closure: A new method for wound control and treatment - clinical experience. Ann Plast Surg, 1997, 38 (6): 563-576.
[3] Ousey K.J, Atkinson R.A, Williamson J.B, Lui S. Negative pressure wound therapy for spinal wounds: a systematic review. Spine J, 2013, 13 (10): 1393-1405, doi:10.1016/j.spinee.2013.06.040
[4] Mehbod A.A, Ogilvie J.W, Pinto M.R et al. Postoperative deep wound infections in adults after spinal fusion: management with vacuum-assisted wound closure. J Spinal Disord Tech, 2005, 18 (1): 14-17.
[5] Labler L, Keel M, Trentz O, Heinzelmann M. Wound conditioning by vacuum-assisted closure in postoperative infections after dorsal spine surgery. Eur Spine J, 2006, 15 (9): 1388-1396, doi:10.1007/s00586-006-0164-2.
[6] Jones G.A, Butler J.A, Lieberman I.H, Schlenk R. Negative-pressure wound therapy in the treatment of complex postoperative spinal wound infections: complications and lessons learned using vacuum-assisted closure. J Neurosurg Spine, 2007, 6 (5): 407-411, doi:10.3171/spi.2007.6.5.407.