Vicario Carlos, de Juan Jesus, Esclarin Ana, Alcobendas Monica
Orthopaedic Surgery Department, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain.
Acta Orthop Belg. 2007 Feb;73(1):102-6.
Postoperative wound infection is a severe complication after spinal instrumentation, especially in a patient with spinal injury. We used vacuum-assisted wound closure (VAC) in two patients with spinal cord injury, who presented deep wound infection after spinal instrumentation and were treated with an aggressive irrigation and debridement procedure. Three and four weeks after VAC application, the hardware was completely covered by granulation tissue and a secondary closure was undertaken. No significant complications were observed. Six months after secondary closure, the wounds remained healed, no signs of instrumentation loosening, haloing or lysis around the instrumentation were observed, and patients had completed their rehabilitation program and were discharged from hospital. Vacuum assisted wound closure appears as an excellent option in the treatment of deep wound infections after spinal instrumentation in patients with spinal cord injury.
术后伤口感染是脊柱内固定术后的一种严重并发症,尤其是在脊髓损伤患者中。我们对两名脊髓损伤患者采用了负压封闭引流(VAC)技术,这两名患者在脊柱内固定术后出现了深部伤口感染,并接受了积极的冲洗和清创手术。在应用VAC技术三到四周后,内固定装置完全被肉芽组织覆盖,随后进行了二期缝合。未观察到明显并发症。二期缝合六个月后,伤口仍愈合良好,未观察到内固定装置松动、光晕形成或内固定周围溶解的迹象,患者已完成康复计划并出院。负压封闭引流似乎是治疗脊髓损伤患者脊柱内固定术后深部伤口感染的一种极佳选择。