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European Journal of Orthopaedic Surgery & Traumatology

Published in:

16-05-2024 | Vacuum Therapy | General Review

Negative pressure wound therapy in the management of postoperative spinal wound infections: a systematic review

Authors: Gaetano Pappalardo, Sascha Schneider, Andreas Kotsias, Madhan Jeyaraman, Luise Schäfer, Filippo Migliorini

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2024

Abstract

Introduction

Postoperative wound infection after spinal surgery might be a challenge to manage. A wide range of procedures have been described for managing infected spinal wounds. An increasingly common procedure in the management of surgical site infections (SSI) is negative pressure wound therapy (NPWT), also known as vacuum-assisted closure. As there is a paucity of clear clinical advice the present investigation aims to update current evidence on the use of NPWT to manage postoperative SSI occurring after instrumented spine surgery.

Methods

This systematic review was conducted according to the preferred reporting Items for systematic reviews and meta-analyses: the 2020 PRISMA statement. In January 2024, the following databases were accessed: PubMed, Web of Science, and Google Scholar. No time constraint was set for the search. All the clinical studies investigating the unique use of NPWT in treating postoperative spinal wound infections were accessed.

Results

A total of 381 patients were included in the present study. Of them 52.5% (200 of 381 patients) were women. The mean age was 52.2 ± 15.2 years. The average length of the NPWT was 21.2 days (range 7–90 days).

Conclusion

NPWT could be a valuable adjuvant therapy for the management of SSI after spine surgery. Additional high-quality investigations are required to assess the efficacy and safety of NPWT in SSI after spine surgery, especially if combined with contraindications or risk factors, such as the presence of intraoperative CSF leak.

Level of evidence

Level IV, Systematic review

Wang X, Lin Y, Yao W, Zhang A, Gao L, Feng F (2023) Surgical site infection in spinal surgery: a bibliometric analysis. J Orthop Surg Res 18(1):337. https://doi.org/10.1186/s13018-023-03813-6CrossRefPubMedPubMedCentral

Nakamura S, Nakai T, Hosozawa K, Tanaka Y, Kishimoto K, Sakata K, Iwata H, Okada S (2022) Treatment strategy for surgical site infection post posterior lumbar interbody fusion: a retrospective study. J Orthop 31:40–44. https://doi.org/10.1016/j.jor.2022.03.004CrossRefPubMedPubMedCentral

Kumagai G, Wada K, Tanaka S, Asari T, Nitobe Y, Ishibashi Y (2022) Association between intraoperative computed tomography navigation system and incidence of surgical site infection in patients with spinal surgeries: a retrospective analysis. J Orthop Surg Res 17(1):52. https://doi.org/10.1186/s13018-022-02936-6CrossRefPubMedPubMedCentral

Järbrink K, Ni G, Sönnergren H, Schmidtchen A, Pang C, Bajpai R, Car J (2017) The humanistic and economic burden of chronic wounds: a protocol for a systematic review. Syst Rev 6(1):15. https://doi.org/10.1186/s13643-016-0400-8CrossRefPubMedPubMedCentral

Whitmore RG, Stephen J, Stein SC, Campbell PG, Yadla S, Harrop JS, Sharan AD, Maltenfort MG, Ratliff JK (2012) Patient comorbidities and complications after spinal surgery: a societal-based cost analysis. Spine (Phila Pa 1976) 37(12):1065–1071. https://doi.org/10.1097/BRS.0b013e31823da22dCrossRefPubMed

Labler L, Keel M, Trentz O, Heinzelmann M (2006) Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery. Eur Spine J 15(9):1388–1396. https://doi.org/10.1007/s00586-006-0164-2CrossRefPubMedPubMedCentral

Mehbod AA, Ogilvie JW, Pinto MR, Schwender JD, Transfeldt EE, Wood KB, Le Huec JC, Dressel T (2005) Postoperative deep wound infections in adults after spinal fusion: management with vacuum-assisted wound closure. J Spinal Disord Tech 18(1):14–17. https://doi.org/10.1097/01.bsd.0000133493.32503.d3CrossRefPubMed

Barker FG 2nd (2002) Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis. Neurosurgery 51(2):391–400 (discussion 400-391)CrossRefPubMed

Brown MD, Brookfield KF (2004) A randomized study of closed wound suction drainage for extensive lumbar spine surgery. Spine (Phila Pa 1976) 29(10):1066–1068. https://doi.org/10.1097/00007632-200405150-00003CrossRefPubMed

10.

Cheng MT, Chang MC, Wang ST, Yu WK, Liu CL, Chen TH (2005) Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery. Spine (Phila Pa 1976) 30(15):1689–1693. https://doi.org/10.1097/01.brs.0000171907.60775.85CrossRefPubMed

11.

Payne DH, Fischgrund JS, Herkowitz HN, Barry RL, Kurz LT, Montgomery DM (1996) Efficacy of closed wound suction drainage after single-level lumbar laminectomy. J Spinal Disord 9(5):401–403CrossRefPubMed

12.

Radcliff KE, Neusner AD, Millhouse PW, Harrop JD, Kepler CK, Rasouli MR, Albert TJ, Vaccaro AR (2015) What is new in the diagnosis and prevention of spine surgical site infections. Spine J 15(2):336–347CrossRefPubMed

13.

Weinstein MA, McCabe JP, Cammisa FP Jr (2000) Postoperative spinal wound infection: a review of 2391 consecutive index procedures. J Spinal Disord 13(5):422–426. https://doi.org/10.1097/00002517-200010000-00009CrossRefPubMed

14.

Wei J, Gu H, Tong K (2023) Intra-wound versus systemic vancomycin for preventing surgical site infection induced by methicillin-resistant S. aureus after spinal implant surgery in a rat model. J Orthop Surg Res 18(1):299. https://doi.org/10.1186/s13018-023-03779-5CrossRefPubMedPubMedCentral

15.

Campbell DH, Dowling TJ, Hah R, Alluri RK, Wang JC (2023) Surgical strategies for spinal infections: A narrative review. N Am Spine Soc J (NASSJ) 16:100293CrossRefPubMed

16.

Richards BR, Emara KM (2001) Delayed infections after posterior TSRH spinal instrumentation for idiopathic scoliosis: revisited. Spine (Phila Pa 1976) 26(18):1990–1996. https://doi.org/10.1097/00007632-200109150-00009CrossRefPubMed

17.

Soultanis K, Mantelos G, Pagiatakis A, Soucacos PN (2003) Late infection in patients with scoliosis treated with spinal instrumentation. Clin Orthop Relat Res 411:116–123. https://doi.org/10.1097/01.blo.0000068357.47147.10CrossRef

18.

Viola RW, King HA, Adler SM, Wilson CB (1997) Delayed infection after elective spinal instrumentation and fusion. A retrospective analysis of eight cases. Spine (Phila Pa 1976) 22(20):2444–2450 (discussion 2450-2441)CrossRefPubMed

19.

Levi AD, Dickman CA, Sonntag VK (1997) Management of postoperative infections after spinal instrumentation. J Neurosurg 86(6):975–980. https://doi.org/10.3171/jns.1997.86.6.0975CrossRefPubMed

20.

Massie JB, Heller JG, Abitbol JJ, McPherson D, Garfin SR (1992) Postoperative posterior spinal wound infections. Clin Orthop Relat Res 284:99–108CrossRef

21.

Sponseller PD, LaPorte DM, Hungerford MW, Eck K, Bridwell KH, Lenke LG (2000) Deep wound infections after neuromuscular scoliosis surgery: a multicenter study of risk factors and treatment outcomes. Spine (Phila Pa 1976) 25(19):2461–2466. https://doi.org/10.1097/00007632-200010010-00007CrossRefPubMed

22.

Stambough JL, Beringer D (1992) Postoperative wound infections complicating adult spine surgery. J Spinal Disord 5(3):277–285. https://doi.org/10.1097/00002517-199209000-00005CrossRefPubMed

23.

Thalgott JS, Cotler HB, Sasso RC, LaRocca H, Gardner V (1991) Postoperative infections in spinal implants. classification and analysis-a multicenter study. Spine (Phila Pa 1976) 16(8):981–984. https://doi.org/10.1097/00007632-199108000-00020CrossRefPubMed

24.

Dumanian GA, Ondra SL, Liu J, Schafer MF, Chao JD (2003) Muscle flap salvage of spine wounds with soft tissue defects or infection. Spine (Phila Pa 1976) 28(11):1203–1211. https://doi.org/10.1097/01.BRS.0000067260.22943.48CrossRefPubMed

25.

Hochberg J, Ardenghy M, Yuen J, Gonzalez-Cruz R, Miura Y, Conrado RM, Pait TG (1998) Muscle and musculocutaneous flap coverage of exposed spinal fusion devices. Plast Reconstr Surg 102(2):385–389 (discussion 390–382)CrossRefPubMed

26.

Mitra A, Mitra A, Harlin S (2004) Treatment of massive thoracolumbar wounds and vertebral osteomyelitis following scoliosis surgery. Plast Reconstr Surg 113(1):206–213. https://doi.org/10.1097/01.PRS.0000097440.15013.5CCrossRefPubMed

27.

Vitaz TW, Oishi M, Welch WC, Gerszten PC, Disa JJ, Bilsky MH (2004) Rotational and transpositional flaps for the treatment of spinal wound dehiscence and infections in patient populations with degenerative and oncological disease. J Neurosurg Spine 100(1 Suppl spine):46–51. https://doi.org/10.3171/spi.2004.100.1.0046CrossRef

28.

Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W (1997) Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 38(6):553–562. https://doi.org/10.1097/00000637-199706000-00001CrossRefPubMed

29.

Bendewald FP, Cima RR, Metcalf DR, Hassan I (2007) Using negative pressure wound therapy following surgery for complex pilonidal disease: a case series. Ostomy Wound Manag 53(5):40–46

30.

DeFranzo AJ, Argenta LC, Marks MW, Molnar JA, David LR, Webb LX, Ward WG, Teasdall RG (2001) The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg 108(5):1184–1191. https://doi.org/10.1097/00006534-200110000-00013CrossRefPubMed

31.

Herscovici D Jr, Sanders RW, Scaduto JM, Infante A, DiPasquale T (2003) Vacuum-assisted wound closure (VAC therapy) for the management of patients with high-energy soft tissue injuries. J Orthop Trauma 17(10):683–688. https://doi.org/10.1097/00005131-200311000-00004CrossRefPubMed

32.

Khurram MF, Sarfraz Ali S, Yaseen M (2019) Vacuum-assisted wound closure therapy in pediatric lower limb trauma. Int J Low Extrem Wounds 18(3):317–322. https://doi.org/10.1177/1534734619857403CrossRefPubMed

33.

Lim HA, Shin J, Jo MS, Chang YJ, Cho DG, Sim HT (2023) Delayed sternal closure using a vacuum-assisted closure system in adult cardiac surgery. J Chest Surg 56(3):206–212. https://doi.org/10.5090/jcs.22.134CrossRefPubMedPubMedCentral

34.

Lopez G, Clifton-Koeppel R, Emil S (2008) Vacuum-assisted closure for complicated neonatal abdominal wounds. J Pediatr Surg 43(12):2202–2207. https://doi.org/10.1016/j.jpedsurg.2008.08.067CrossRefPubMed

35.

Sibbald RG, Mahoney JV (2003) A consensus report on the use of vacuum-assisted closure in chronic, difficult-to-heal wounds. Ostomy Wound Manage 49(11):52–66PubMed

36.

Suliburk JW, Ware DN, Balogh Z, McKinley BA, Cocanour CS, Kozar RA, Moore FA, Ivatury RR (2003) Vacuum-assisted wound closure achieves early fascial closure of open abdomens after severe trauma. J Trauma 55(6):1155–1160 (discussion 1160-1151)CrossRefPubMed

37.

Howick J CI, Glasziou P, Greenhalgh T, Carl Heneghan, Liberati A, Moschetti I, Phillips B, Thornton H, Goddard O, Hodgkinson M (2011) The 2011 Oxford CEBM levels of evidence. Oxford Centre for Evidence-Based Medicine Available at https://www.cebmnet/indexaspx?o=5653

38.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hrobjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71CrossRefPubMedPubMedCentral

39.

Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J (2019) Updated guidance for trusted systematic reviews: a new edition of the cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev 10(10):ED000142. https://doi.org/10.1002/14651858.ED000142CrossRefPubMed

40.

Sterne JA, Hernan MA, Reeves BC, Savovic J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hrobjartsson A, Kirkham J, Juni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schunemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 355:i4919CrossRefPubMedPubMedCentral

41.

McGuinness LA, Higgins JPT (2021) Risk-of-bias VISualization (robvis): An R package and shiny web app for visualizing risk-of-bias assessments. Res Synth Methods 12(1):55–61. https://doi.org/10.1002/jrsm.1411CrossRefPubMed

42.

Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A, Stephenson M, Aromataris E (2020) Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth 18(10):2127–2133. https://doi.org/10.11124/JBISRIR-D-19-00099CrossRefPubMed

43.

Adogwa O, Fatemi P, Perez E, Moreno J, Gazcon GC, Gokaslan ZL, Cheng J, Gottfried O, Bagley CA (2014) Negative pressure wound therapy reduces incidence of postoperative wound infection and dehiscence after long-segment thoracolumbar spinal fusion: a single institutional experience. Spine J 14(12):2911–2917. https://doi.org/10.1016/j.spinee.2014.04.011CrossRefPubMed

44.

Canavese F, Gupta S, Krajbich JI, Emara KM (2008) Vacuum-assisted closure for deep infection after spinal instrumentation for scoliosis. J Bone Joint Surg Br 90(3):377–381. https://doi.org/10.1302/0301-620X.90B3.19890CrossRefPubMed

45.

Jones GA, Butler J, Lieberman I, Schlenk R (2007) Negative-pressure wound therapy in the treatment of complex postoperative spinal wound infections: complications and lessons learned using vacuum-assisted closure. J Neurosurg Spine 6(5):407–411. https://doi.org/10.3171/spi.2007.6.5.407CrossRefPubMed

46.

Kale M, Padalkar P, Mehta V (2017) Vacuum-assisted closure in patients with post-operative infections after instrumented spine surgery: a series of 12 cases. J Orthop Case Rep 7(1):95–100. https://doi.org/10.13107/jocr.2250-0685.706CrossRefPubMedPubMedCentral

47.

Karaaslan F, Erdem S, Mermerkaya MU (2015) Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis. Int Med Case Rep J 8:7–11. https://doi.org/10.2147/IMCRJ.S76214CrossRefPubMed

48.

Kurra S, Rashid A, Yirenkyi H, Castle P, Lavelle WF (2020) Outcomes of negative pressure wound therapies in the management of spine surgical site wound infections. Int J Spine Surg 14(5):772–777. https://doi.org/10.14444/7110CrossRefPubMedPubMedCentral

49.

Lee R, Beder D, Street J, Boyd M, Fisher C, Dvorak M, Paquette S, Kwon B (2018) The use of vacuum-assisted closure in spinal wound infections with or without exposed dura. Eur Spine J 27(10):2536–2542. https://doi.org/10.1007/s00586-018-5612-2CrossRefPubMed

50.

Patel RS, Wang SSY, Ramos MRD, Najjar HWN, Prasad SV, Kumar N (2019) Vacuum-assisted closure: an effective technique to manage wound complications after metastatic spine tumour surgery (MSTS)-a case report. Int J Spine Surg 13(6):544–550. https://doi.org/10.14444/6074CrossRefPubMedPubMedCentral

51.

Ploumis A, Mehbod AA, Dressel TD, Dykes DC, Transfeldt EE, Lonstein JE (2008) Therapy of spinal wound infections using vacuum-assisted wound closure: risk factors leading to resistance to treatment. J Spinal Disord Tech 21(5):320–323. https://doi.org/10.1097/BSD.0b013e318141f99dCrossRefPubMed

52.

Rickert M, Rauschmann M, Latif-Richter N, Arabmotlagh M, Rahim T, Schmidt S, Fleege C (2023) Management of deep spinal wound infections following instrumentation surgery with subfascial negative pressure wound therapy. J Neurol Surg Cent Eur Neurosurg 84(1):30–36. https://doi.org/10.1055/s-0040-1720999CrossRef

53.

Ridwan S, Grote A, Simon M (2020) Safety and efficacy of negative pressure wound therapy for deep spinal wound infections after dural exposure, durotomy, or intradural surgery. World Neurosurg 134:e624–e630. https://doi.org/10.1016/j.wneu.2019.10.146CrossRefPubMed

54.

Shi H, Zhu L, Jiang ZL, Huang ZH, Wu XT (2021) The use of incisional vacuum-assisted closure system following one-stage incision suture combined with continuous irrigation to treat early deep surgical site infection after posterior lumbar fusion with instrumentation. J Orthop Surg Res 16(1):445. https://doi.org/10.1186/s13018-021-02588-yCrossRefPubMedPubMedCentral

55.

van Rhee MA, de Klerk LW, Verhaar JA (2007) Vacuum-assisted wound closure of deep infections after instrumented spinal fusion in six children with neuromuscular scoliosis. Spine J 7(5):596–600. https://doi.org/10.1016/j.spinee.2006.09.002CrossRefPubMed

56.

West JM, Jordan SW, Mendel E, Khan SN, Chandawarkar RY, Valerio IL (2018) Instillation negative pressure wound therapy: an effective tool for complex spine wounds. Adv Wound Care (New Rochelle) 7(10):333–338. https://doi.org/10.1089/wound.2018.0793CrossRefPubMed

57.

Zeng J, Sun X, Sun Z, Guan J, Han C, Zhao X, Zhang P, Xie Y, Zhao J (2019) Negative pressure wound therapy versus closed suction irrigation system in the treatment of deep surgical site infection after lumbar surgery. World Neurosurg 127:e389–e395. https://doi.org/10.1016/j.wneu.2019.03.130CrossRefPubMed

58.

Zhang H, Li Q (2018) Improved vacuum sealing drainage for treatment of surgical site infection following posterior spinal internal fixation: a case report. Medicine (Baltimore) 97(7):e9952. https://doi.org/10.1097/MD.0000000000009952CrossRefPubMed

59.

Zwolak P, Konig MA, Osterhoff G, Wilzeck V, Simmen HP, Jukema GN (2013) Therapy of acute and delayed spinal infections after spinal surgery treated with negative pressure wound therapy in adult patients. Orthop Rev (Pavia) 5(4):e30. https://doi.org/10.4081/or.2013.e30CrossRefPubMed

60.

Chahoud J, Kanafani Z, Kanj SS (2014) Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. Front Med 1:7CrossRef

61.

Barbanti-Brodano G, Griffoni C, Halme J, Tedesco G, Terzi S, Bandiera S, Ghermandi R, Evangelisti G, Girolami M, Pipola V (2020) Spinal surgery complications: an unsolved problem–is the world health organization safety surgical checklist an useful tool to reduce them? Eur Spine J 29:927–936CrossRefPubMed

62.

Chaudhary SB, Vives MJ, Basra SK, Reiter MF (2007) Postoperative spinal wound infections and postprocedural diskitis. J Spinal Cord Med 30(5):441–451. https://doi.org/10.1080/10790268.2007.11753476CrossRefPubMedPubMedCentral

63.

Dowdell J, Brochin R, Kim J, Overley S, Oren J, Freedman B, Cho S (2018) Postoperative spine infection: diagnosis and management. Global Spine J 8(4 Suppl):37S-43S. https://doi.org/10.1177/2192568217745512CrossRefPubMedPubMedCentral

64.

Ogihara S, Yamazaki T, Shiibashi M, Chikuda H, Maruyama T, Miyoshi K, Inanami H, Oshima Y, Azuma S, Kawamura N (2021) Risk factors for deep surgical site infection following posterior instrumented fusion for degenerative diseases in the thoracic and/or lumbar spine: a multicenter, observational cohort study of 2913 consecutive cases. Eur Spine J 30:1756–1764CrossRefPubMed

65.

Spatenkova V, Bradac O, Jindrisek Z, Hradil J, Fackova D, Halacova M (2021) Risk factors associated with surgical site infections after thoracic or lumbar surgery: a 6-year single centre prospective cohort study. J Orthop Surg Res 16(1):265. https://doi.org/10.1186/s13018-021-02418-1CrossRefPubMedPubMedCentral

66.

Wang SK, Wang P, Li XY, Kong C, Niu JY, Lu SB (2022) Incidence and risk factors for early and late reoperation following lumbar fusion surgery. J Orthop Surg Res 17(1):385. https://doi.org/10.1186/s13018-022-03273-4CrossRefPubMedPubMedCentral

67.

Deng H, Chan AK, Ammanuel S, Chan AY, Oh T, Skrehot HC, Edwards S, Kondapavulur S, Nichols AD, Liu C, Yue JK, Dhall SS, Clark AJ, Chou D, Ames CP, Mummaneni PV (2019) Risk factors for deep surgical site infection following thoracolumbar spinal surgery. J Neurosurg Spine 32(2):292–301. https://doi.org/10.3171/2019.8.SPINE19479CrossRefPubMed

68.

Gerometta A, Rodriguez Olaverri JC, Bitan F (2012) Infections in spinal instrumentation. Int Orthop 36(2):457–464. https://doi.org/10.1007/s00264-011-1426-0CrossRefPubMedPubMedCentral

69.

Haleem A, Chiang HY, Vodela R, Behan A, Pottinger JM, Smucker J, Greenlee JD, Clark C, Herwaldt LA (2016) Risk factors for surgical site infections following adult spine operations. Infect Control Hosp Epidemiol 37(12):1458–1467. https://doi.org/10.1017/ice.2016.193CrossRefPubMed

70.

Ojo OA, Owolabi BS, Oseni AW, Kanu OO, Bankole OB (2016) Surgical site infection in posterior spine surgery. Niger J Clin Pract 19(6):821–826. https://doi.org/10.4103/1119-3077.183237CrossRefPubMed

71.

Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, Fraser VJ (2008) Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am 90(1):62–69. https://doi.org/10.2106/JBJS.F.01515CrossRefPubMed

72.

Anderson PA, Savage JW, Vaccaro AR, Radcliff K, Arnold PM, Lawrence BD, Shamji MF (2017) Prevention of surgical site infection in spine surgery. Neurosurgery 80(3S):S114–S123. https://doi.org/10.1093/neuros/nyw066CrossRefPubMed

73.

Ogihara S, Yamazaki T, Shiibashi M, Maruyama T, Chikuda H, Miyoshi K, Inanami H, Oshima Y, Azuma S, Kawamura N, Yamakawa K, Hara N, Morii J, Okazaki R, Takeshita Y, Sato K, Tanaka S, Saita K (2020) Risk factor analysis of deep surgical site infection after posterior instrumented fusion surgery for spinal trauma: a multicenter observational study. World Neurosurg 134:e524–e529. https://doi.org/10.1016/j.wneu.2019.10.117CrossRefPubMed

74.

Yang YF, Yu JC, Xiao Z, Kang YJ, Zhou B (2023) Role of pre-operative nutrition status on surgical site infection after posterior lumbar interbody fusion: a retrospective study. Surg Infect (Larchmt) 24(10):942–948. https://doi.org/10.1089/sur.2023.051CrossRefPubMed

75.

Zhou J, Wang R, Huo X, Xiong W, Kang L, Xue Y (2020) Incidence of surgical site infection after spine surgery: a systematic review and meta-analysis. Spine (Phila Pa 1976) 45(3):208–216. https://doi.org/10.1097/BRS.0000000000003218CrossRefPubMed

76.

Dowdell J, Brochin R, Kim J, Overley S, Oren J, Freedman B, Cho S (2018) Postoperative spine infection: diagnosis and management. Glob Spine J 8(4_suppl):37S-43SCrossRef

77.

Chaudhary SB, Vives MJ, Basra SK, Reiter MF (2007) Postoperative spinal wound infections and postprocedural diskitis. J Spinal Cord Med 30(5):441CrossRefPubMedPubMedCentral

78.

Behringer M, Link TW, Montag JC, McCourt ML, Mester J (2015) Are electrically induced muscle cramps able to increase the cramp threshold frequency, when induced once a week? Orthop Rev (Pavia) 7(3):6028. https://doi.org/10.4081/or.2015.6028CrossRefPubMed

79.

Beiner JM, Grauer J, Kwon BK, Vaccaro AR (2003) Postoperative wound infections of the spine. Neurosurg Focus 15(3):E14. https://doi.org/10.3171/foc.2003.15.3.14CrossRefPubMed

80.

Bible JE, Biswas D, Devin CJ (2011) Postoperative infections of the spine. Am J Orthop (Belle Mead NJ) 40(12):E264-271PubMed

81.

Sales JG, Tabrizi A, Elmi A, Soleimanpour J, Gavidel E (2013) Adolescence spinal epidural abscess with neurological symptoms: case report, a lesson to be re-learnt. Med J Islam Repub Iran 27(1):38PubMedPubMedCentral

82.

Lenehan B, Sullivan P, Street J, Dudeney S (2005) Epidural abscess causing cauda equina syndrome. Ir J Med Sci 174(3):88–91. https://doi.org/10.1007/bf03169156CrossRefPubMed

83.

Chahoud J, Kanafani Z, Kanj SS (2014) Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. Front Med (Lausanne) 1:7. https://doi.org/10.3389/fmed.2014.00007CrossRefPubMed

84.

Daldal I, Senkoylu A (2020) Strategies of management of deep spinal infection: from irrigation and debridement to vacuum-assisted closure treatment. Ann Transl Med 8(2):33. https://doi.org/10.21037/atm.2019.11.60CrossRefPubMedPubMedCentral

85.

Ousey KJ, Atkinson RA, Williamson JB, Lui S (2013) Negative pressure wound therapy (NPWT) for spinal wounds: a systematic review. Spine J 13(10):1393–1405. https://doi.org/10.1016/j.spinee.2013.06.040CrossRefPubMed

86.

Meredith DS, Kepler CK, Huang RC, Brause BD, Boachie-Adjei O (2012) Postoperative infections of the lumbar spine: presentation and management. Int Orthop 36(2):439–444. https://doi.org/10.1007/s00264-011-1427-zCrossRefPubMed

87.

White AJ, Fiani B, Jarrah R, Momin AA, Rasouli J (2022) Surgical site infection prophylaxis and wound management in spine surgery. Asian Spine J 16(3):451–461. https://doi.org/10.31616/asj.2020.0674CrossRefPubMed

88.

Rycerz AM, Allen D, Lessing MC (2013) Science supporting negative pressure wound therapy with instillation. Int Wound J 10 Suppl 1(Suppl 1):20–24. https://doi.org/10.1111/iwj.12171CrossRefPubMed

89.

Orgill DP, Bayer LR (2013) Negative pressure wound therapy: past, present and future. Int Wound J 10 Suppl 1(Suppl 1):15–19. https://doi.org/10.1111/iwj.12170CrossRefPubMed

90.

Venturi ML, Attinger CE, Mesbahi AN, Hess CL, Graw KS (2005) Mechanisms and clinical applications of the vacuum-assisted closure (VAC) device: a review. Am J Clin Dermatol 6(3):185–194. https://doi.org/10.2165/00128071-200506030-00005CrossRefPubMed

91.

Normandin S, Safran T, Winocour S, Chu CK, Vorstenbosch J, Murphy AM, Davison PG (2021) Negative pressure wound therapy: mechanism of action and clinical applications. Semin Plast Surg 35(3):164–170. https://doi.org/10.1055/s-0041-1731792CrossRefPubMedPubMedCentral

92.

Horch RE, Ludolph I, Muller-Seubert W, Zetzmann K, Hauck T, Arkudas A, Geierlehner A (2020) Topical negative-pressure wound therapy: emerging devices and techniques. Expert Rev Med Devices 17(2):139–148. https://doi.org/10.1080/17434440.2020.1714434CrossRefPubMed

93.

Agarwal P, Kukrele R, Sharma D (2019) Vacuum assisted closure (VAC)/negative pressure wound therapy (NPWT) for difficult wounds: a review. J Clin Orthop Trauma 10(5):845–848. https://doi.org/10.1016/j.jcot.2019.06.015CrossRefPubMedPubMedCentral

94.

Huang C, Leavitt T, Bayer LR, Orgill DP (2014) Effect of negative pressure wound therapy on wound healing. Curr Probl Surg 51(7):301–331CrossRefPubMed

95.

Contractor D, Amling J, Brandoli C, Tosi LL (2008) Negative pressure wound therapy with reticulated open cell foam in children: an overview. J Orthop Trauma 22(10 Suppl):S167-176. https://doi.org/10.1097/BOT.0b013e318188e295CrossRefPubMed

96.

Morykwas MJ, Faler BJ, Pearce DJ, Argenta LC (2001) Effects of varying levels of subatmospheric pressure on the rate of granulation tissue formation in experimental wounds in swine. Ann Plast Surg 47(5):547–551. https://doi.org/10.1097/00000637-200111000-00013CrossRefPubMed

97.

McCord SS, Naik-Mathuria BJ, Murphy KM, McLane KM, Gay AN, Bob Basu C, Downey CR, Hollier LH, Olutoye OO (2007) Negative pressure therapy is effective to manage a variety of wounds in infants and children. Wound Repair Regen 15(3):296–301. https://doi.org/10.1111/j.1524-475X.2007.00229.xCrossRefPubMed

98.

Scalise A, Calamita R, Tartaglione C, Pierangeli M, Bolletta E, Gioacchini M, Gesuita R, Di Benedetto G (2016) Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of incisional negative pressure wound therapy. a systematic review of the literature. Int wound J 13(6):1260–1281CrossRefPubMed

99.

Norman G, Shi C, Goh EL, Murphy EM, Reid A, Chiverton L, Stankiewicz M, Dumville JC (2022) Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane Database Syst Rev 4(4):CD009261. https://doi.org/10.1002/14651858.CD009261.pub7CrossRefPubMed

100.

Armstrong DG, Lavery LA (2005) Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet 366(9498):1704–1710. https://doi.org/10.1016/S0140-6736(05)67695-7CrossRefPubMed

101.

Yuan-Innes MJ, Temple CL, Lacey MS (2001) Vacuum-assisted wound closure: a new approach to spinal wounds with exposed hardware. Spine (Phila Pa 1976) 26(3):E30-33. https://doi.org/10.1097/00007632-200102010-00006CrossRefPubMed

102.

Khan KA, Choudhary M, Sinha VD, Gora N, Bairwa M (2019) Predictors of outcome after traumatic brain injuries: Experience of a Tertiary Health Care Institution in Northwest India. World Neurosurg 126:e699–e705. https://doi.org/10.1016/j.wneu.2019.02.126CrossRefPubMed

103.

Naylor RM, Gilder HE, Gupta N, Hydrick TC, Labott JR, Mauler DJ, Trentadue TP, Ghislain B, Elder BD, Fogelson JL (2020) Effects of negative pressure wound therapy on wound dehiscence and surgical site infection following instrumented spinal fusion surgery-a single surgeon’s experience. World Neurosurg 137:e257–e262. https://doi.org/10.1016/j.wneu.2020.01.152CrossRefPubMedPubMedCentral

Title: Negative pressure wound therapy in the management of postoperative spinal wound infections: a systematic review
Authors: Gaetano Pappalardo
Sascha Schneider
Andreas Kotsias
Madhan Jeyaraman
Luise Schäfer
Filippo Migliorini
Publication date: 16-05-2024
Publisher: Springer Paris
Keywords: Vacuum Therapy
Vacuum Therapy
Vacuum Therapy
Wound Infection
Spinal Surgery
Postoperative Wound Infection
Postoperative Wound Infection
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-024-03983-x

2024 ESC Congress

Springer Medicine

Negative pressure wound therapy in the management of postoperative spinal wound infections: a systematic review

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

2024 ESC Congress

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

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