[The treatment of deep wound infection after posterior thoracic and lumbar instrumentation].
OBJECTIVE
To study the characteristics and treatment of the deep wound infection after thoracic and lumbar instrumentation.


METHODS
Thirty-six cases of deep wound infection after thoracic and lumbar instrumentation were retrospectively reviewed. There were acute deep wound infection in 14 cases and delayed infection in 22 cases. The patients with acute infection were treated with debridement and continuous irrigation and suction. Internal fixators were removed in 3 cases for repeated infection. The patients with delayed infection were treated with internal fixator removal, debridement and continuous irrigation and suction.


RESULTS
At follow-up evaluation, only 1 patient had recurrence of infection because of his complicating vertebral osteomyelitis. The most common organisms cultured in acute deep wound infection were staphylococcus aureus and colibacillus while staphylococcus epidermis, micrococcus and diphtheria bacillus in delayed infection. The white cell count and ESR were elevated in the acute deep wound infection while only the ESR elevated and the white cell count remained normal in the delayed deep wound infection.


CONCLUSIONS
There may be different between the acute and delayed deep wound infection's pathology. The internal fixator could be remained in the acute deep wound infection which need be removed in the delayed deep wound infection.
Chen
Fei
F
Department of Spine Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China. chenfei91138@sina.com
Lü
Guo-hua
GH
Kang
Yi-jun
YJ
Wang
Bing
B
Li
Jing
J
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy*; D007507:Therapeutic Irrigation; D013904:Thoracic Vertebrae / Q000601:surgery*
D000900:Anti-Bacterial Agents