Negative Pressure Wound Therapy for Prevention of Post-Operative Wound Complications in Posterior Spinal Surgery: A 10-Year Retrospective Study
Joan Francine U. Perez, MD; Agustin Miguel G. Morales MD, FPOA; Jose Joeffrey F. Arbatin MD, FPOA; Oliver Y. Ong MD, FPOA; Eric Astelo O. Berlarmino, MD, FPOA
Surgical site infection after a lumbar spine surgery is a serious complication with significant morbidity and economic burden. Studies from European populations report infection rates ranging from 9.3 to 20%. Despite numerous interventions, including prophylactic antibiotics use, improvements in surgical techniques, and postoperative care, it continues to affect patients after lumbar surgery causing an increase in hospital stay duration, re-operation rates, and additional treatment costs. Vacuum-assisted closure dressing has recently been gaining popularity in the management of open wounds. This study aims to review the use of the vacuum assisted closure dressing in the prevention of both superficial and deep infections after posterior spinal instrumentation surgery.
Study design: This is a retrospective study with the population taken from a private tertiary hospital in Cebu. Patients selected were those who underwent posterior spinal surgery (cervical, thoracic, lumbar); those treated with negative pressure wound therapy postoperatively from January 2017 to May 2021; patients who were treated with traditional sterile dressing/closed suction drain postoperatively from May 2011 to December 2016; patients who sustained surgical site infections postoperatively and Patients with any of the 3 types of surgical site infection (superficial, deep and organ or space SSI).
Results: Between May 2011-May 2021, 7 out of 378 patients developed both superficial and deep infections after spinal surgery with traditional dressing postoperatively and only 4 patients developed a superficial infection using VAC dressing postoperatively. All patients had achieved clean closed post-operative sites along with retention of their instrumentation. None of the patients had a recurrence after the treatment.
Conclusion: The study demonstrates the usefulness of vacuum assisted closure dressing in prevention of surgical site infections after instrumented spine surgeries as it eliminates prolonged use of antibiotics, extended hospital stays, subsequent procedures or removal of the implants.