Canavese Federico, Krajbich Joseph I
Department of Orthopedics, Shriners Hospital for Children, 3101 SW Sam Jackson Park Road, Oregon 97239, Portland, USA.
Indian J Orthop. 2010 Apr;44(2):177-83. doi: 10.4103/0019-5413.62067.
Postoperative deep infections are relatively common in children with instrumented spinal deformities, whose healing potential is somewhat compromised. Children with underlying diagnosis of cerebral palsy, spina bifida and other chronic debilitating conditions are particularly susceptible. Vacuum-assisted closure (VAC) is a newer technique to promote healing of wounds resistant to treatment by established methods. This article aims to review the efficacy of the VAC system in the treatment of deep spinal infections following spinal instrumentation and fusion in children and adolescents.
We reviewed 33 patients with deep postoperative surgical site infection treated with wound VAC technique. We reviewed clinical and laboratory data, including the ability to retain the spinal hardware, loss of correction and recurrent infections.
All patients successfully completed their wound VAC treatment regime. None had significant loss of correction and one had persistent infection requiring partial hardware removal. The laboratory indices normalized in all but three patients.
Wound VAC technique is a useful tool in the armamentarium of the spinal surgeon dealing with patients susceptible to wound infections, especially those with neuromuscular diseases. It allows for retention of the instrumentation and maintenance of the spinal correction. It is reliable and easy to use.
在接受脊柱内固定治疗的脊柱畸形患儿中，术后深部感染相对常见，其愈合潜力有所受损。患有脑瘫、脊柱裂及其他慢性衰弱性疾病等基础疾病的儿童尤其易感。负压封闭引流（VAC）是一种促进对传统治疗方法耐药伤口愈合的新技术。本文旨在综述VAC系统在治疗儿童及青少年脊柱内固定及融合术后深部脊柱感染中的疗效。
我们回顾了33例接受伤口VAC技术治疗的术后手术部位深部感染患者。我们回顾了临床和实验室数据，包括保留脊柱内固定器械的能力、矫正丢失情况及反复感染情况。
所有患者均成功完成伤口VAC治疗方案。无一例出现明显的矫正丢失，1例出现持续性感染，需要部分取出内固定器械。除3例患者外，所有患者的实验室指标均恢复正常。
伤口VAC技术是脊柱外科医生治疗易发生伤口感染患者（尤其是患有神经肌肉疾病的患者）的有用工具。它有助于保留内固定器械并维持脊柱矫正。它可靠且易于使用。
