Pedicled omental flaps as an adjunct in the closure of complex spinal wounds.
METHODS
A retrospective clinical study.


OBJECTIVE
To evaluate the safety and efficacy of using an omental flap in complex spine reconstruction in patients at high-risk for wound dehiscence.


BACKGROUND
Postoperative wound dehiscence represents a major cause of morbidity in patients undergoing instrumented spinal reconstruction. A variety of approaches for the prevention and treatment of this problem have been previously described in the literature; however, the use of omental flaps has received little attention.


METHODS
In this retrospective analysis, 5 patients were studied both clinically and radiographically. The study population included 4 women and 1 man, with a mean age of 49 years (range, 31-67 years). All patients underwent an omental flap procedure at the time of spinal reconstruction because of significant soft tissue defects or active spinal infection. Mean clinicoradiographic follow-up was 53 months (range, 36-115 months).


RESULTS
At the time of follow-up, all patients had well-healed surgical wounds with an acceptable structural and esthetic result. One patient in the study group experienced minor supra-fascial wound dehiscence. In terms of spinal outcome, all patients achieved successful bony arthrodesis; 1 patient, however, developed symptomatic adjacent segment degeneration and was treated by extension of the fusion construct.


CONCLUSIONS
In patients undergoing thoracolumbar surgery who are at high risk of spinal wound dehiscence, closure using a pedicled omental flap is a viable procedure that may limit the risk of dehiscence and improve outcome.
O'Shaughnessy
Brian A
BA
Department of Neurological Surgery and Division of Plastic Surgery, Feinberg School of Medicine, McGaw Medical Center, Northwestern University, Chicago, IL 60611, USA.
Dumanian
Gregory A
GA
Liu
John C
JC
Ganju
Aruna
A
Ondra
Stephen L
SL
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum; D010019:Osteomyelitis / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013116:Spinal Cord / Q000601:surgery*; D013122:Spinal Diseases / Q000601:surgery; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000517:prevention & control