With more and more people having spine surgery, the number of cases of wound infection has also increased. In this report, surgeons from St. Louis University tell about their experience using vacuum-assisted closure (VAC) to treat wound infections.
VAC consists of a spongy foam dressing cut into the shape of the wound and placed directly over the opening. The dressing must make firm and even contact with the entire wound surface. Part of the VAC system is a pump that is used to remove fluid and debris from the wound site. A drain tube is inserted through the foam dressing into the wound. Any excess fluid or wound debris is taken out through the tube.
Eleven patients who had posterior spinal surgery and developed a wound infection were included in the review. All were treated with antibiotics until the wounds were healed. Before applying the VAC, the infected and necrotic (dead) tissue was removed. The wound site was irrigated (cleaned out) with saline (salt solution).
A wound VAC was placed on the open wound and changed every 48 hours. VAC therapy continued until the wound closed. This took anywhere from two to five weeks. Ten of the 11 patients had complete healing. One patient did not return for follow-up.
Preventing infections is an important goal after spinal surgery. The surgeon must assess patient and operative risk factors before doing the operation. If an infection does occur, a quick response is needed to avoid having to remove the hardware used to help fuse the spine.
The VAC system removes bacteria and keeps new bacteria from entering the wound. Removing excess fluid helps improve circulation for faster healing. Other studies show that VAC helps decrease the size of the wound making healing more likely.