Division of Spinal Surgery, St. George's University Hospitals NHS Foundation Trust, London, UK.
Department of Spinal Surgery, Basildon Hospital NHS Foundation Trust, Essex, UK.
Int Wound J. 2020 Jun;17(3):729-734. doi: 10.1111/iwj.13332. Epub 2020 Feb 19.
Assess the outcome of a standardised protocol for the treatment of post-operative wound infection in patients undergoing deformity correction for neuro-muscular scoliosis (NMS). Retrospective review of 443 consecutive patients with a minimum 18 months' follow-up, following a primary posterior deformity correction for NMS. In patients who developed a wound complication, the patient demographic and comorbidities, causative pathogen, number of re-operations, length of stay (LOS), rate of cure, and complications were analysed. Forty-four patients (9.9%) developed a wound infection. Marginally more infections were mono-microbial (23) than poly-microbial (21). Coagulase negative staphylococcus and Staphylococcus aureus were the most commonly cultured pathogens. Seventeen patients were treated with antibiotics alone, while 27 patients also required surgical debridement. The average LOS for those treated with antibiotics alone was 12 days (range: 9-15 days), in contrast to those requiring debridement, which was 35 days (range: 35-70 days). All patients were cured from their infection and ultimately achieved fusion. Infection is common in NMS deformity correction. This is marginally more common as a mono-microbial than poly-microbial infection with most pathogens being staphylococcal in origin. Our defined treatment strategy resulted in a cure for all patients and capacity for all patients to achieve fusion.
评估用于治疗神经肌肉性脊柱侧凸（NMS）畸形矫正术后伤口感染的标准化方案的结果。对 443 例接受初次后路畸形矫正的 NMS 患者进行了回顾性研究，随访时间至少为 18 个月。在发生伤口并发症的患者中，分析了患者的人口统计学和合并症、病原体、再次手术次数、住院时间（LOS）、治愈率和并发症。44 名患者（9.9%）发生了伤口感染。单微生物感染（23 例）略多于多微生物感染（21 例）。凝固酶阴性葡萄球菌和金黄色葡萄球菌是最常见的培养病原体。17 名患者单独使用抗生素治疗，而 27 名患者还需要手术清创。单独使用抗生素治疗的患者的平均 LOS 为 12 天（范围：9-15 天），而需要清创的患者为 35 天（范围：35-70 天）。所有患者的感染均治愈并最终实现融合。感染在 NMS 畸形矫正中很常见。这种感染作为一种单微生物感染比多微生物感染更为常见，大多数病原体为葡萄球菌。我们定义的治疗策略使所有患者都治愈，并使所有患者都有能力实现融合。
