title: Therapy of acute and delayed spinal infections after spinal surgery treated with negative pressure wound therapy in adult patients.
abstract: We present the results of the treatment of infected primary or delayed spine wounds after spinal surgery using negative pressure wound therapy. In our institution (University Hospital Zurich, Switzerland) nine patients (three women and six men; mean age 68.6, range 43-87 years) were treated in the period between January to December 2011 for non-healing spinal wounds. The treatment consisted of repeated debridements, irrigation and temporary closure with negative pressure wound therapy system. Three patients were admitted with a spinal epidural abscess; two with osteoporotic lumbar fracture; two with pathologic vertebra fracture and spinal cord compression, and two with vertebra fracture after trauma. All nine patients have been treated with antibiotic therapy. In one case the hardware has been removed, in three patients laminectomy was performed without instrumentation, in five patients there was no need to remove the hardware. The average hospital stay was 16.6 days (range 11-30). The average follow-up was 3.8, range 0.5-14 months. The average number of negative pressure wound therapy procedures was three, with the range 1-11. Our retrospective study focuses on the clinical problems faced by the spinal surgeon, clinical outcomes after spinal surgery followed by wound infection, and negative pressure wound therapy. Moreover, we would like to emphasize the importance for the patients and their relatives to be fully informed about the increased complications of surgery and about the limitations of treatment of these wounds with negative pressure wound therapy.
authors.affiliation: Department of Trauma Surgery, University Hospital Zurich , Switzerland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Zwolak
authors.affiliation: Department of Trauma Surgery, University Hospital Zurich , Switzerland.
authors.forename: Matthias Alexander
authors.initials: MA
authors.lastname: König
authors.affiliation: Department of Trauma Surgery, University Hospital Zurich , Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Osterhoff
authors.affiliation: Department of Trauma Surgery, University Hospital Zurich , Switzerland.
authors.forename: Verena
authors.initials: V
authors.lastname: Wilzeck
authors.affiliation: Department of Trauma Surgery, University Hospital Zurich , Switzerland.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Simmen
authors.affiliation: Department of Trauma Surgery, University Hospital Zurich , Switzerland.
authors.forename: Gerrolt Nico
authors.initials: GN
authors.lastname: Jukema
keywords: infection; spinal infections; spinal surgery; vacuum assisted therapy