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  • Negative Pressure Wound Therapy Reduces Incidence of Post-Operative Wound Infection and Dehiscence After Long-Segment Thoracolumbar Spinal Fusion: A Single Institutional Experience.

    Final Number:
    405

    Authors:
    Owoicho Adogwa M.D. M.P.H; Parastou Fatemi; Terence Verla; Edgar Perez; Gustavo Chagoya BS; Jessica Rose Moreno RN, BSN; Joseph S. Cheng MD MS; Oren N. Gottfried MD; Carlos Antonio Bagley MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Notwithstanding the use of prophylactic systemic antibiotics, post-operative wound dehiscence and surgical site infections (SSI) after spine surgery remain of serious concern--as they often require hospital re-admission, additional surgical interventions, lengthy IV antibiotic administration and delayed rehabilitation. Negative pressure wound therapy exposes the wound site to negative pressure, resulting in the improvement of blood supply, removal of excess fluid and stimulation of cellular proliferation of granulation tissue. The aim of this study was to assess the incidence of wound infection and dehiscence in deformity patients undergoing thoracolumbar fusion after the routine use of negative pressure wound therapy.

    Methods: All adult patients undergoing thoracolumbar fusion for spinal deformity over a six-year period at Duke University Medical Center by the senior author (C.B.) were included in this study.In 2012, a categorical change was made by the senior author (C.B.) that included the post-operative routine use of negative pressure wound therapy (NPWT) after primary wound closure in all long-segment spine fusions. After primary wound closure, a negative pressure device is contoured to the size of the incision and placed over the incision site for 3 post-operative days. We retrospectively review the first 46 cases in which NPWT was utilized. a

    Results: 160 (NPWT: 46 cases, non- NPWT: 114 cases) thoracolumbar spine fusions were performed for deformity correction. Baseline characteristics were similar between both cohorts. Compared to the non-NPWT cohort, a 50% decrease in the incidence of wound dehiscence was observed in the NPWT cohort (6.38% vs. 12.28%, p=0.02). Similarly, Compared to the non-NPWT cohort, the incidence of post-operative SSI’s was significantly decreased in the NPWT cohort (10.63% vs. 14.91%, p=0.04).

    Conclusions: For patients undergoing thoracolumbar fusion, routine use of negative pressure wound therapy was associated with a significant reduction in the incidence of post-operative wound infection and dehiscence.

    Patient Care: For patients undergoing long-segment thoracolumbar fusion, routine use of negative pressure wound therapy was associated with a significant reduction in the incidence of post-operative wound infection and dehiscence.

    Learning Objectives: For patients undergoing long-segment thoracolumbar fusion, routine use of negative pressure wound therapy was associated with a significant reduction in the incidence of post-operative wound infection and dehiscence.

    References:

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