Department of Plastic & Reconstructive Surgery, Medical University of South Carolina, SC.
Department of Neurosurgery, Medical University of South Carolina, SC.
Spine (Phila Pa 1976). 2020 May 1;45(9):599-604. doi: 10.1097/BRS.0000000000003341.
MINI: This retrospective case series investigated paraspinous flaps for coverage of complex spinal wounds. 6.90% of patients developed postoperative wound infections and 0.00% of patients required instrumentation removal for infection. This suggests that these flaps may offer a long-term solution in wound management for patients with repeated spinal operations.
Retrospective case series.
To investigate the efficacy and complication profile of the use of paraspinous muscle flaps for closure of complex spinal wounds.
Paraspinous muscle flap closure offers an innovative option in difficult-to-manage post-spinal surgery wounds. Current literature reports are mixed in terms of success and complication rates of these flap procedures, with most sources citing a wound complication rate of 20%.
This case series investigated the hospital course of 58 patients undergoing paraspinous flap closure after spinal surgery between the years 2014 and 2018. Information gathered includes: demographics, surgery indication, location, and length of incision on the spine, nutrition labs, previous spinal surgeries, preoperative wound class, operative times, length of hospital stay, and complication rates including reoperation, wound infection, and other postoperative complications.
Of the 58 patients undergoing spinal muscle flap closure, 51 (87.93%) had undergone previous spinal surgery with an average of 2.12 previous surgeries in these patients. Mean albumin and prealbumin were 2.62 and 13.75, respectively. 4/58 (6.90%) developed a wound infection or experienced a continuation of their chronic osteomyelitis. Of the 57 patients that had spinal instrumentation, three (5.26%) had spinal implants removed at the time of surgery and two (3.51%) had it removed or replaced later for mechanical complications. No patients had instrumentation removed for chronic infections. One (1.72%) experienced reoperation for wound-related complications. These rates are lower than most complication rates in the current literature.
The plastic and reconstructive paraspinous muscle flap has promising results as a closure option for complex spinal wounds following neurosurgical cases. Further investigation is called for to determine the applicability of these results to the general population.
MINI：本回顾性病例系列研究了用于覆盖复杂脊柱伤口的脊柱旁皮瓣。6.90%的患者发生术后伤口感染，0.00%的患者因感染需要去除器械。这表明，对于反复进行脊柱手术的患者，这些皮瓣可能是一种长期的伤口管理解决方案。
回顾性病例系列研究。
探讨使用脊柱旁肌肉皮瓣闭合复杂脊柱伤口的疗效和并发症情况。
脊柱旁肌肉皮瓣闭合为难以处理的脊柱手术后伤口提供了一种创新选择。目前的文献报道在这些皮瓣手术的成功率和并发症发生率方面存在差异，大多数来源报道的皮瓣手术并发症发生率为 20%。
本病例系列研究了 2014 年至 2018 年间 58 例接受脊柱手术后脊柱旁皮瓣闭合的患者的住院过程。收集的信息包括：人口统计学资料、手术适应证、脊柱部位、切口长度、营养实验室检查、既往脊柱手术、术前伤口分级、手术时间、住院时间和并发症发生率，包括再次手术、伤口感染和其他术后并发症。
在接受脊柱肌肉皮瓣闭合的 58 例患者中，51 例（87.93%）曾接受过脊柱手术，这些患者平均有 2.12 次既往手术。平均白蛋白和前白蛋白分别为 2.62 和 13.75。4/58（6.90%）发生伤口感染或慢性骨髓炎持续存在。在 57 例有脊柱器械的患者中，3 例（5.26%）在手术时去除了脊柱植入物，2 例（3.51%）因机械并发症而去除或更换了植入物。没有患者因慢性感染而去除器械。1 例（1.72%）因伤口相关并发症而再次手术。这些比率低于当前文献中的大多数并发症比率。
整形和重建脊柱旁肌肉皮瓣作为神经外科手术后复杂脊柱伤口的闭合选择具有良好的效果。需要进一步研究以确定这些结果对一般人群的适用性。
4 级。
