Vacuum-assisted wound closure of deep infections after instrumented spinal fusion in six children with neuromuscular scoliosis

BACKGROUND CONTEXT: The rate of infection after spinal fusion in neuromuscular scoliosis is reported to range from 4% to 20%. Infection persists in about 50% after traditional treatment including debridement and closure. Instrumentation removal is necessary in up to 28%. PURPOSE: To analyze the outcome of vacuum-assisted wound closure (VAC) in combination with antibiotics for the treatment of deep wound infection after instrumented spinal fusion in pediatric neuromuscular scoliosis. STUDY DESIGN: Six prospective consecutive neuromuscular patients with scoliosis. PATIENT SAMPLE: Between 2001 and 2005, six consecutive pediatric patients (average age, 12.6 years) with neuromuscular scoliosis with a postoperative deep wound infection after instrumented spinal fusion were included in the study. OUTCOME MEASURES: Measurement of the duration of wound closure and infection parameters during treatment. METHODS: The patients were treated with a VAC system in combination with antibiotics. RESULTS: Wound closure averaged 3 months. Infection parameters were normalized within 6 weeks. Removal of the instrumentation was not necessary in any patient, and there were no signs of infection at follow-up ranging from 9 to 42 months. CONCLUSION: The VAC system, in combination with antibiotic therapy, seems to be a useful method for treatment of deep wound infections after spinal fusion in pediatric neuromuscular scoliosis. It may prevent removal of the instrumentation and multiple surgery for irrigation and closure of the wound.

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