Positive Bacterial Cultures on Spinal Wound Closure Do Not Predict Postoperative Outcomes

Area of Science:

• Plastic Surgery
• Wound Management
• Infectious Disease

Background:

• Complex surgical back wounds are a significant source of morbidity following spinal procedures.
• Plastic surgery intervention is often required for closure or revision of these wounds.
• Assessing the utility of bacterial wound culture data is key for predicting surgical outcomes.

Purpose of the Study:

• To evaluate the predictive value of bacterial wound culture data in managing complex surgical back wounds.
• To determine the association between wound culture results and postoperative complications.
• To identify factors influencing healing time and reconstructive success.

Main Methods:

• Retrospective review of 70 patients undergoing plastic surgery for post-spinal procedure wound infections (2010-2021).
• Statistical analysis of demographics, comorbidities, perioperative data, and treatment methods.
• Primary outcomes: postoperative complications and reconstructive failure; Secondary outcome: time to healing.

Main Results:

• Overall complication rate was 31.4%, including infection (12.9%), seroma (10%), and dehiscence (12.9%).
• Positive wound cultures were only associated with an increased risk of seroma (OR, 0.265).
• Vacuum-assisted closure devices reduced dehiscence (OR, 0.179) and improved healing (HR, 3.638).

Conclusions:

• Bacterial wound cultures did not significantly correlate with negative outcomes in complex spinal surgical wound management.
• Clinical judgment and a multidisciplinary approach are paramount for managing these wounds.
• Culture data should not be the sole determinant for wound closure timing.