Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Int Wound J. 2021 Apr;18(2):158-163. doi: 10.1111/iwj.13507. Epub 2020 Nov 25.
Post-operative wound complications are some of the most common acute complications following spine surgery. These surgical site infections (SSI) contribute to increased healthcare related costs. Negative pressure wound therapy (NPWT) has long been used for treatment of soft tissue injury or defects. NPWT may reduce the incident of SSI following spinal fusion procedures; however, its potential applications need further clarification. Thus, we conducted a retrospective analysis of two cohorts to compare NPWT to traditional sterile dressings following spinal fusions in regards to post-operative outcomes. Following institutional review board approval, 42 patients who had a NPWT were matched by type of surgery to 42 patients who had traditional dressings. A retrospective chart-review was completed. Outcome measures, particularly SSI and need for reoperation, were analyzed using one-way ANOVA for both univariate and multivariate analysis. When controlled for sex and body-mass index, the use of a NPWT was independently correlated with decreased SSI (P = .035). Superficial dehiscence, seroma, need for additional outpatient care, and need for operative revision were all found to occur at higher rates in the traditional dressing cohort. Closed incisional negative pressure wound therapy provides a cost-effective method of decreasing surgical site infection for posterior elective spine surgeries.
术后伤口并发症是脊柱手术后最常见的急性并发症之一。这些手术部位感染(SSI)会导致医疗保健相关成本增加。负压伤口治疗(NPWT)长期以来一直用于治疗软组织损伤或缺陷。NPWT 可能会降低脊柱融合手术后 SSI 的发生率;然而,其潜在应用需要进一步澄清。因此,我们对两个队列进行了回顾性分析,比较了脊柱融合术后 NPWT 与传统无菌敷料在术后结果方面的差异。在获得机构审查委员会批准后,根据手术类型将接受 NPWT 的 42 名患者与接受传统敷料的 42 名患者进行匹配。完成了回顾性图表审查。使用单因素和多因素分析的方差分析分析了手术结局,特别是 SSI 和再次手术的需要。当控制性别和体重指数时,使用 NPWT 与 SSI 降低独立相关(P =.035)。在传统敷料组中,发现浅层裂开、血清肿、需要额外的门诊治疗以及需要手术修正的发生率均更高。闭合性切口负压伤口治疗为后路择期脊柱手术减少手术部位感染提供了一种具有成本效益的方法。