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Using Vacuum-Assisted Closure with Spinal Wound Infections

Infection after spinal surgery is fairly common. A new treatment for deep infections of the spine is discussed in this study. This treatment is called vacuum-assisted closure (VAC). It is a negative pressure dressing with a special suction device to remove drainage.

Sixteen patients with spinal wound infections were treated with VAC at the Cleveland Spine Clinic in Ohio. They all received intravenous antibiotic therapy as well. Thirteen of the patients were followed for at least three months. The VAC device was used anywhere from 90 days up to two years.

The results of individual cases are presented. Patients ranged in age from 14 to 76 years old. Spine surgery was done to correct a deformity from scoliosis in a young woman and for degenerative scoliosis in an older woman. One man had kidney cancer that had spread to his spine. Another middle-aged man had infections of the disc (discitis) and vertebral bones (osteomyelitis).

The authors report their study was too small in number and too short of a follow-up time to present the effectiveness of VAC. There were some complications from blood loss in their patients. One patient developed problems from a piece of packing strip from the dressing. It was left inside the wound after the VAC was removed.

VAC has been used with success in other operations such as heart, orthopedic, and plastic surgeries. The authors suggest that the VAC system should be used with caution in spinal wound infections. There are risks of bleeding with VAC. Failure of the wound to close may require additional surgery. It can also be a fatal complication of VAC.

References: G. Alexander Jones, MD, et al. Negative-Pressure Wound Therapy in the Treatment of Complex Postoperative Spinal Wound Infections: Complications and Lessons Learned Using Vacuum-Assisted Closure. In Journal of Neurosurgery: Spine. May 2007. Vol. 6. No. 5. Pp. 407-411.

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