Improved vacuum sealing drainage for therapy of surgical website an infection following posterior spinal inner fixation: A case report.
Drugs (Baltimore). 2018 Feb;97(7):e9952
Authors: Zhang H, Li Q
RATIONALE: Surgical website an infection (SSI) following backbone surgical procedures involving inner fixation typically require eradicating the instrument; nonetheless, this could trigger spinal instability. Earlier studies have demonstrated the usefulness of vacuum sealing drainage (VSD) remedy, however the circumstances 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 inner 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 had been constructive for Enterococcus faecalis. Subsequently, 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 had been positioned into the wound from the exudation website of the wound till they contacted the inner fixation gadgets. After overlaying exterior fixation gadgets, steady drainage was carried out for 24?h. The VSD gadget was changed each four to five days till the wound effusion stopped. All the operations had been carried out on the bedside with out complicated manipulation or secondary closure underneath harsh aseptic situation.
OUTCOMES: Wound exudation decreased remarkably and the an infection was managed 2 weeks after the appliance 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 website of the wound was sutured. After 7 weeks, full wound therapeutic was achieved and no an infection recurred throughout the 6-month follow-up.
LESSONS: VSD might be a dependable therapy for SSIs that require preservation of inner fixation. Full opening of the wound throughout the VSD therapy and secondary wound closure surgical procedure had been averted.
PMID: 29443786 [PubMed – indexed for MEDLINE]