Wound management in spinal infection.

Wound management in the spine-infected patient is a complex problem. Treatment is determined by the primary diagnosis, which may have bearing on wound healing. The most common site of wounds requiring plastic surgical intervention in the neurologically intact patient is in the posterior thoracic area. In spinal cord-injured patients, the most common site is in the lumbosacral area. The cause of these wounds are iatrogenic because of infection after attempted thoracic fusion in the first case. In the spinal cord-injured patient it is caused either by postoperative infection or extension of a pressure ulcer in the area of insensate skin. Preoperative preparation is a prerequisite before wound closure. Muscle and myocutaneous flaps represent the best options in managing these complex wounds.