Native muscle flaps decrease post-operative wound morbidity in sufferers with neoplastic illness of the backbone.
Clin Neurol Neurosurg. 2018 Might 29;171:100-105
Authors: Franck P, Bernstein JL, Cohen LE, Härtl R, Baaj AA, Spector JA
OBJECTIVES: Sufferers with neoplastic illness involving the backbone both from main or metastatic illness current a singular problem given these sufferers’ frequent poor dietary standing on the time of surgical procedure, the supply of early post-operative chemotherapy or radiation, and placement of huge quantities of and avascular bone graft right into a wound mattress that’s atrophic, beforehand operated or irradiated. In consequence, wound morbidity has historically been excessive on this cohort of sufferers. Herein we assessment the outcomes of sufferers at our establishment who underwent native muscle flap closure following spinal tumor extirpation.
PATIENTS AND METHODS: Between 2007 and 2017, 55 sufferers with oncologic illness of the backbone underwent 60 backbone surgical procedures and concomitant muscle flap reconstruction. Charts had been retrospectively reviewed for prognosis and indications for surgical procedure, in addition to threat components for poor wound therapeutic together with diabetes, steroid use, physique mass index (BMI), historical past of pre-operative chemo and or radiation remedy, preoperative albumin and hemoglobin ranges. Outcomes had been postoperative wound associated problems together with surgical web site an infection, wound dehiscence and/or want for reoperation.
RESULTS: 60 reconstructions had been included in 55 sufferers. Median comply with up was 253 days. Paraspinous muscle flaps had been utilized in all circumstances. There have been 2 main problems (three.three%) associated to wound infections which required reoperation and 10 minor wound problems (16.7%), of which 9 had been subcutaneous seromas aspirated within the workplace, that didn’t require return to the working room. Median postoperative keep within the hospital was 10 days. Closed suction drains positioned on the finish of the reconstruction had been eliminated at a median of 17.5 days. Regression evaluation discovered affected person BMI to be a major threat predictor for wound associated post-operative problems.
CONCLUSIONS: Put up-operative wound particular problems that required return to the working room had been unusual regardless of the high-risk profile of this subset of sufferers. These knowledge point out that muscle flap closure needs to be routinely practiced on this high-risk cohort of sufferers.
PMID: 29890458 [PubMed – as supplied by publisher]