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Instillation Negative Pressure Wound Therapy: An Effective Tool for Complex Spine Wounds
Julie M West, PA
Nichole E Zayan, BS
Sumanas W Jordan, MD PhD
Rajiv Y Chandawarkar, MD
Ian L Valerio, MD
Ohio State University
2018-02-15
Presenter: Nichole Zayan
Affidavit:
The student drafted the abstract.
Director Name: Ian Valerio
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Infection prevention in spinal surgeries involving implantation of hardware is of utmost priority. Furthermore, successful eradication of infection in hardware salvage is likewise critical in maintaining the long-term retention of the spinal hardware construct. Herein, we report a series of three cases where the utilization of an instillation negative pressure wound therapy system (iNPWT) in conjunction with surgical debridement aided in infection control and eradication for both pre-implantation and hardware salvage spine patients. In case one, iNPWT was utilized in the setting of acute preoperative infection to eradicate infection and enable necessary spinal hardware implementation. Following completion resection and iNPWT with IV antibiotics, the patient successfully underwent vertebral decompression, spinal fusion, and bilateral paraspinous muscle flaps and a right trapezius flap closure. Cases two and three are representative of iNPWT for salvage of exposed spinal hardware in both the early and delayed infection presentation settings. In both cases, patients developed postoperative infections following spinal instrumentation and iNPWT was utilized in conjunction with surgical debridement and IV antibiotics. Hardware removal was avoided in both cases. All patients healed completely without residual evidence of infection. Our case series demonstrates that iNPWT can provide infection eradication both pre-operatively in high-risk surgical sites, facilitating necessary hardware implementation and post-operatively in situations of hardware salvage.
