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Improved vacuum sealing drainage for therapy of surgical web site an infection following posterior spinal inside fixation: A case report.
Drugs (Baltimore). 2018 Feb;97(7):e9952
Authors: Zhang H, Li Q
Summary
RATIONALE: Surgical web site an infection (SSI) following backbone surgical procedures involving inside fixation usually require eradicating the instrument; nevertheless, this will trigger spinal instability. Earlier studies have demonstrated the usefulness of vacuum sealing drainage (VSD) remedy, however the instances require wound opening, aseptic situation to switch the VSD gadget, and a secondary operation to shut the wound. Thus, to enhance the VSD therapy and develop a maneuverable process, make sense in backbone surgical procedure.
PATIENTS CONCERNS: A 59-year-old male affected person with a T12 vertebral fracture was affected by SSIs after spinal osteotomy with inside fixation.
DIAGNOSES: The affected person complained of wound exudation and had a fever three weeks after posterior spinal surgical procedure. Preliminary serum investigations confirmed elevated white blood cell depend and bacterial cultures of wound exudate have been optimistic for Enterococcus faecalis. Due to this fact, SSI is confirmed.
INTERVENTIONS: The an infection was not managed after 2 debridements, so the affected person was handled with VSD therapy. The VSD foam dressings containing a drainage tube have been positioned into the wound from the exudation web site of the wound till they contacted the inner fixation units. After overlaying exterior fixation units, steady drainage was carried out for 24?h. The VSD gadget was changed each four to five days till the wound effusion stopped. The entire operations have been carried out on the bedside with out complicated manipulation or secondary closure beneath harsh aseptic situation.
OUTCOMES: Wound exudation decreased remarkably and the an infection was managed 2 weeks after the applying of VSD therapy. After 5 weeks, inflammatory indicators all decreased to regular ranges and the exudate of the wound had stopped. The VSD therapy was then terminated and the drainage web site of the wound was sutured. After 7 weeks, full wound therapeutic was achieved and no an infection recurred through the 6-month follow-up.
LESSONS: VSD could possibly be a dependable therapy for SSIs that require preservation of inside fixation. Full opening of the wound through the VSD therapy and secondary wound closure surgical procedure have been averted.
PMID: 29443786 [PubMed – indexed for MEDLINE]