Instillation Negative Pressure Wound Therapy: An Effective Tool for Complex Spine Wounds

Area of Science:

• Spine Surgery
• Infectious Disease
• Wound Management

Background:

• Spinal hardware implantation carries a high risk of surgical site infections.
• Effective infection control is crucial for hardware retention and patient outcomes.
• Hardware salvage in infected cases presents significant challenges.

Purpose of the Study:

• To evaluate the efficacy of negative pressure wound therapy with instillation (VACi) in managing spinal surgical site infections.
• To assess VACi's role in both pre-implantation infection eradication and post-operative hardware salvage.
• To present a case series demonstrating VACi's application in complex spinal infection scenarios.

Main Methods:

• Retrospective case series of three patients undergoing spinal surgery.
• Application of VACi combined with surgical debridement and intravenous antibiotics.
• Utilized VACi for pre-implantation infection control and post-operative hardware salvage.

Main Results:

• VACi facilitated infection eradication in a pre-implantation setting, enabling hardware placement.
• VACi aided in salvaging spinal hardware in two post-operative infection cases, avoiding removal.
• All three patients achieved complete healing without residual infection.

Conclusions:

• VACi is an effective adjunct for eradicating infections in high-risk spinal surgical sites.
• VACi demonstrates utility in both preventing infections before hardware implantation and salvaging infected hardware post-operatively.
• This approach can help preserve spinal hardware constructs and improve patient recovery.