Improved vacuum sealing drainage for treatment of surgical site infection following posterior spinal internal fixation: A case report.
Medicine (Baltimore)
; 97(7): e9952, 2018 Feb.
Article
en En
| MEDLINE
| ID: mdl-29443786
ABSTRACT
RATIONALE Surgical site infection (SSI) following spine surgeries involving internal fixation often require removing the instrument; however, this can cause spinal instability. Previous reports have demonstrated the usefulness of vacuum sealing drainage (VSD) therapy, but the cases require wound opening, aseptic condition to replace the VSD device, and a secondary operation to close the wound. Thus, to improve the VSD treatment and develop a maneuverable procedure, make sense in spine surgery. PATIENTS CONCERNS A 59-year-old male patient with a T12 vertebral fracture was affected by SSIs after spinal osteotomy with internal fixation. DIAGNOSES The patient complained of wound exudation and had a fever 3 weeks after posterior spinal surgery. Initial serum investigations showed elevated white blood cell count and bacterial cultures of wound exudate were positive for Enterococcus faecalis. Therefore, SSI is confirmed. INTERVENTIONS:
The infection was not controlled after 2 debridements, so the patient was treated with VSD treatment. The VSD foam dressings containing a drainage tube were placed into the wound from the exudation site of the wound until they contacted the internal fixation devices. After covering external fixation devices, continuous drainage was performed for 24âh. The VSD device was replaced every 4 to 5 days until the wound effusion stopped. All of the operations were performed at the bedside without complex manipulation or secondary closure under harsh aseptic condition.OUTCOMES:
Wound exudation decreased remarkably and the infection was controlled 2 weeks after the application of VSD treatment. After 5 weeks, inflammatory indicators all decreased to normal levels and the exudate of the wound had stopped. The VSD treatment was then terminated and the drainage site of the wound was sutured. After 7 weeks, complete wound healing was achieved and no infection recurred during the 6-month follow-up. LESSONS VSD could be a reliable treatment for SSIs that require preservation of internal fixation. Complete opening of the wound during the VSD treatment and secondary wound closure surgery were avoided.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteotomía
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Infección de la Herida Quirúrgica
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Vértebras Torácicas
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Fracturas de la Columna Vertebral
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Terapia de Presión Negativa para Heridas
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Fijación Interna de Fracturas
Tipo de estudio:
Etiology_studies
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Año:
2018
Tipo del documento:
Article