Skip to main content

Advertisement

SpringerLink
Log in

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

  • General Review
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available throughout the manuscript.

References

  1. 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/s13018-023-03813-6

    Article  PubMed  PubMed Central  Google Scholar 

  2. 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.2022.03.004

    Article  PubMed  PubMed Central  Google Scholar 

  3. 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/s13018-022-02936-6

    Article  PubMed  PubMed Central  Google Scholar 

  4. 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/s13643-016-0400-8

    Article  PubMed  PubMed Central  Google Scholar 

  5. 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.0b013e31823da22d

    Article  PubMed  Google Scholar 

  6. 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/s00586-006-0164-2

    Article  PubMed  PubMed Central  Google Scholar 

  7. 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.d3

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  9. 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/10.1097/00007632-200405150-00003

    Article  PubMed  Google Scholar 

  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.0000171907.60775.85

    Article  PubMed  Google Scholar 

  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):401–403

    Article  CAS  PubMed  Google Scholar 

  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):336–347

    Article  PubMed  Google Scholar 

  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/10.1097/00002517-200010000-00009

    Article  CAS  PubMed  Google Scholar 

  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/s13018-023-03779-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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) 16:100293

    Article  PubMed  Google Scholar 

  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/10.1097/00007632-200109150-00009

    Article  CAS  PubMed  Google Scholar 

  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.0000068357.47147.10

    Article  Google Scholar 

  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)

    Article  CAS  PubMed  Google Scholar 

  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.1997.86.6.0975

    Article  CAS  PubMed  Google Scholar 

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

    Article  Google Scholar 

  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/10.1097/00007632-200010010-00007

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  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/10.1097/00007632-199108000-00020

    Article  CAS  PubMed  Google Scholar 

  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.0000067260.22943.48

    Article  PubMed  Google Scholar 

  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)

    Article  CAS  PubMed  Google Scholar 

  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.0000097440.15013.5C

    Article  PubMed  Google Scholar 

  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.2004.100.1.0046

    Article  Google Scholar 

  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/10.1097/00000637-199706000-00001

    Article  CAS  PubMed  Google Scholar 

  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

    Google Scholar 

  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/10.1097/00006534-200110000-00013

    Article  CAS  PubMed  Google Scholar 

  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/10.1097/00005131-200311000-00004

    Article  PubMed  Google Scholar 

  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/10.1177/1534734619857403

    Article  CAS  PubMed  Google Scholar 

  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.22.134

    Article  PubMed  PubMed Central  Google Scholar 

  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.2008.08.067

    Article  PubMed  Google Scholar 

  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):52–66

    PubMed  Google Scholar 

  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)

    Article  PubMed  Google Scholar 

  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.n71

    Article  PubMed  PubMed Central  Google Scholar 

  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.ED000142

    Article  PubMed  Google Scholar 

  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:i4919

    Article  PubMed  PubMed Central  Google Scholar 

  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.1411

    Article  PubMed  Google Scholar 

  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-19-00099

    Article  PubMed  Google Scholar 

  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.2014.04.011

    Article  PubMed  Google Scholar 

  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.90B3.19890

    Article  CAS  PubMed  Google Scholar 

  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.2007.6.5.407

    Article  PubMed  Google Scholar 

  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.2250-0685.706

    Article  PubMed  PubMed Central  Google Scholar 

  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.S76214

    Article  PubMed  Google Scholar 

  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/10.14444/7110

    Article  PubMed  PubMed Central  Google Scholar 

  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/s00586-018-5612-2

    Article  PubMed  Google Scholar 

  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/10.14444/6074

    Article  PubMed  PubMed Central  Google Scholar 

  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.0b013e318141f99d

    Article  PubMed  Google Scholar 

  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-0040-1720999

    Article  Google Scholar 

  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.2019.10.146

    Article  PubMed  Google Scholar 

  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-y

    Article  PubMed  PubMed Central  Google Scholar 

  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.2006.09.002

    Article  PubMed  Google Scholar 

  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.2018.0793

    Article  PubMed  Google Scholar 

  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.2019.03.130

    Article  PubMed  Google Scholar 

  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.0000000000009952

    Article  PubMed  Google Scholar 

  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.e30

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  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 29:927–936

    Article  PubMed  Google Scholar 

  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/10.1080/10790268.2007.11753476

    Article  PubMed  PubMed Central  Google Scholar 

  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/10.1177/2192568217745512

    Article  PubMed  PubMed Central  Google Scholar 

  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 30:1756–1764

    Article  PubMed  Google Scholar 

  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/s13018-021-02418-1

    Article  PubMed  PubMed Central  Google Scholar 

  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/s13018-022-03273-4

    Article  PubMed  PubMed Central  Google Scholar 

  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.SPINE19479

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  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.2016.193

    Article  PubMed  Google Scholar 

  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/10.4103/1119-3077.183237

    Article  CAS  PubMed  Google Scholar 

  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.01515

    Article  PubMed  Google Scholar 

  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/nyw066

    Article  PubMed  Google Scholar 

  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.2019.10.117

    Article  PubMed  Google Scholar 

  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.2023.051

    Article  PubMed  Google Scholar 

  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.0000000000003218

    Article  PubMed  Google Scholar 

  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-43S

    Article  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  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.2015.6028

    Article  PubMed  Google Scholar 

  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.2003.15.3.14

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  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):38

    PubMed  PubMed Central  Google Scholar 

  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/bf03169156

    Article  CAS  PubMed  Google Scholar 

  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.2014.00007

    Article  PubMed  Google Scholar 

  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.2019.11.60

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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.2013.06.040

    Article  PubMed  Google Scholar 

  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-z

    Article  PubMed  Google Scholar 

  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.2020.0674

    Article  PubMed  Google Scholar 

  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.12171

    Article  PubMed  Google Scholar 

  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.12170

    Article  PubMed  Google Scholar 

  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/10.2165/00128071-200506030-00005

    Article  PubMed  Google Scholar 

  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-0041-1731792

    Article  PubMed  PubMed Central  Google Scholar 

  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/10.1080/17434440.2020.1714434

    Article  CAS  PubMed  Google Scholar 

  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.2019.06.015

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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.0b013e318188e295

    Article  PubMed  Google Scholar 

  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/10.1097/00000637-200111000-00013

    Article  CAS  PubMed  Google Scholar 

  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.x

    Article  PubMed  Google Scholar 

  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):1260–1281

    Article  PubMed  Google Scholar 

  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.pub7

    Article  PubMed  Google Scholar 

  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)67695-7

    Article  PubMed  Google Scholar 

  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/10.1097/00007632-200102010-00006

    Article  CAS  PubMed  Google Scholar 

  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.2019.02.126

    Article  PubMed  Google Scholar 

  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.2020.01.152

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Department of Spine Surgery, Oberlinhaus, 14482, Potsdam, Germany

    Gaetano Pappalardo, Sascha Schneider & Andreas Kotsias

  2. Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, 600077, India

    Madhan Jeyaraman

  3. Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, 39100, Bolzano, Italy

    Luise Schäfer & Filippo Migliorini

Authors
  1. Gaetano Pappalardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sascha Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andreas Kotsias
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Madhan Jeyaraman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luise Schäfer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Filippo Migliorini
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Gaetano Pappalardo involved in literature search, data extraction, quality assessment; Sascha Schneider involved in writing; Andreas Kotsias: writing; Madhan Jeyaraman involved in writing; Luise Schäfer involved in literature search, data extraction, quality assessment; Filippo Migliorini involved in writing, statistical analyses. All authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Filippo Migliorini.

Ethics declarations

Conflict of interest

The authors declare that they have any competing interests for this article.

Ethical approval

This study complies with ethical standards.

Registration and protocol

The present review was not registered.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pappalardo, G., Schneider, S., Kotsias, A. et al. Negative pressure wound therapy in the management of postoperative spinal wound infections: a systematic review. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03983-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00590-024-03983-x

Keywords

Search

Navigation