Negative pressure wound therapy combined with reversed latissimus dorsi muscle flap for postoperative deep infection after spinal instrumentation
10.3760/cma.j.issn.1671-7600.2018.02.010
- VernacularTitle:创面负压治疗联合背阔肌肌瓣逆行翻转技术在治疗脊柱内固定术后深部感染中的应用
- Author:
Liangyu GAN
1
;
Kun XIE
;
Bing WEN
Author Information
1. 100034,北京大学第一医院整形烧伤科
- Keywords:
Spine;
Internal fixators;
Negative-pressure wound therapy;
Latissimus dorsi muscle flap;
Implant infection
- From:
Chinese Journal of Orthopaedic Trauma
2018;20(2):147-151
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore a potentially effective treatment of postoperative deep infection after spinal instrumentation without removal of implants. Methods A total of 4 patients with postoperative deep infection after spinal instrumentation were treated at our hospital between January 2015 and May 2016. They were 2 men and 2 women, aged from 62 to 75 years (mean, 69.2 years). They were treated with ag-gressive surgical debridement under the guidance of methylene blue and negative pressure wound therapy. Reversed latissimus dorsi muscle flap was used to obturate the wound when the bacterial culture of the wound was negative and the relevant inflammatory indicators returned to normal. Negative pressure treatment con-tinued over the closed incision. Results The devices for negative pressure wound therapy were removed in the 4 patients one week after surgery. All the wounds were healed well by first intention 2 weeks after surgery without removal of their implants. The patients were discharged after their examinations for blood routine, CRP, ESR and PCT turned to be normal. Follow-ups for more than one year revealed no re-infection, implants loosening or other adverse effects. Conclusions Negative pressure wound therapy combined with reversed latissimus dorsi muscle flap is a new attempt to treat postoperative deep infection after spinal instru-mentation without implant removal. It may increase the rate of implants reserved, accelerate wound healing and raise the curative rate of deep infection.
