Vacuum-assisted wound closure of deep infections after instrumented spinal fusion in six children with neuromuscular scoliosis.
BACKGROUND
The rate of infection after spinal fusion in neuromuscular scoliosis is reported to range from 4% to 20%. Infection persists in about 50% after traditional treatment including debridement and closure. Instrumentation removal is necessary in up to 28%.


OBJECTIVE
To analyze the outcome of vacuum-assisted wound closure (VAC) in combination with antibiotics for the treatment of deep wound infection after instrumented spinal fusion in pediatric neuromuscular scoliosis.


METHODS
Six prospective consecutive neuromuscular patients with scoliosis.


METHODS
Between 2001 and 2005, six consecutive pediatric patients (average age, 12.6 years) with neuromuscular scoliosis with a postoperative deep wound infection after instrumented spinal fusion were included in the study.


METHODS
Measurement of the duration of wound closure and infection parameters during treatment.


METHODS
The patients were treated with a VAC system in combination with antibiotics.


RESULTS
Wound closure averaged 3 months. Infection parameters were normalized within 6 weeks. Removal of the instrumentation was not necessary in any patient, and there were no signs of infection at follow-up ranging from 9 to 42 months.


CONCLUSIONS
The VAC system, in combination with antibiotic therapy, seems to be a useful method for treatment of deep wound infections after spinal fusion in pediatric neuromuscular scoliosis. It may prevent removal of the instrumentation and multiple surgery for irrigation and closure of the wound.
van Rhee
Marina A
MA
Division of Orthopedic Surgery, Erasmus University Medical Centre and Sophia University Children's Hospital, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
de Klerk
Luuk W L
LW
Verhaar
Jan A N
JA
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000628:therapy*; D013396:Suction / Q000295:instrumentation; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome; D014618:Vacuum; D014945:Wound Healing
D000900:Anti-Bacterial Agents