Vacuum-Assisted Closure: An Effective Technique to Manage Wound Complications After Metastatic Spine Tumour Surgery (MSTS)-A Case Report.
NPWT
metastatis
negative pressure wound therapy
spine surgery
surgical site infections
vacuum-assisted closure, VAC
wound complications
Journal
International journal of spine surgery
ISSN: 2211-4599
Titre abrégé: Int J Spine Surg
Pays: Netherlands
ID NLM: 101579005
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
entrez:
24
1
2020
pubmed:
24
1
2020
medline:
24
1
2020
Statut:
epublish
Résumé
The management of wound complications following metastatic spine tumor surgery (MSTS) remains a formidable task. Plastic coverage procedures after MSTS are challenging due to unhealthy donor sites following previous radiotherapy and prolonged nonambulation. Negative pressure wound therapy (NPWT) is usually not recommended after MSTS due to fear of tumor seeding and excessive blood loss. However, in certain patients post-MSTS, who may be considered as receiving palliative treatment, NPWT can be effective in managing wound complications. We describe our initial experience with the use of NPWT in a 57-year-old lady diagnosed with multiple lumbar and cervicothoracic vertebral metastases secondary to non-small cell lung carcinoma. She underwent 2 cycles of preoperative radiotherapy followed by decompression and posterior instrumentation of lumbosacral and cervicothoracic regions succeeded by another cycle of radiotherapy. The patient developed wound dehiscence and poly-microbial surgical site infection that was not responsive to regular debridements and antibiotics. Hence, we applied NPWT as an alternative treatment to plastic surgical procedures. The patient clinically improved with a reduced quantity of wound discharge, increased granulation tissue, and a downward trend in the inflammatory markers. Subsequently, wound was secondarily closed after 14 days. The patient was discharged after a total hospital stay of 41 days. The intravenous antibiotics (piperacillin/tazobactam) were changed to oral (ciprofloxacin) after 6 weeks and continued for 4 months. The patient survived for 3 years without any wound complications. Our case report suggests that NPWT can be a potential treatment option for managing wound complications following MSTS.
Identifiants
pubmed: 31970050
doi: 10.14444/6074
pmc: PMC6962007
doi:
Types de publication
Journal Article
Langues
eng
Pagination
544-550Informations de copyright
©International Society for the Advancement of Spine Surgery 2019.
Déclaration de conflit d'intérêts
Disclosures and COI: The authors received no funding for this study and report no conflicts of interest.
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