Clinical Analysis Of 12 Patients With Postoperative Deep Wound Infections After Spinal Instrumentation.

Background and object Postoperative deep wound infections is one of the severe complication after spinal instrumentation, which can pose local soft tissue like muscle, skin engorgement and necrosis, even make the implant reveal, that makes treatment very tough. Although the incidence rate of postoperative deep wound infections after spinal instrumentation is different in each single report, it is certain that the chance of infection is increase along with the use of the implant. Pass analysis the impact factor, earlier period diagnosis, appear time and treatment way of postoperative deep wound infections, To study the clinical characteristics of postoperative deep wound infections after spinal instrumentation.Methods Twelve patients with Postoperative deep wound infections were discovered and treated after spinal instrumentation through 2005 to 2007. Among them, 3 cases were underwent posterior cervical surgery, 1 case was underwent posterior thoracic surgery, 5 cases were underwent posterior lumbar surgery, 2 cases were underwent posterior thoracolumbar surgery, and 1 case was underwent anterior lumbar surgery. 9 cases are diagnosed as acute infections, 3 cases as late-developing infections. Contrast literature report of infection impact factor statistics surgical operation time, operative site, and the quantity of blood lose during operation. The diagnosis standards of infection are clinical situation, laboratory examination result, bacteria culture. The treatment of the infection consists of operative debridement and irrigation of the infected wound, a course of intravenous followed by oral antibiotic medications. Adjust the treatment project, base on the treatment effect.Results Although the count of white blood cell and the ratio of neutrophil cell of the late-developing infections, may remain at a normal high level, the erythrocyte sedimentation rate(ESR) and the c-reactive protein(CRP) increase above the normal high level, which can prompt the infection better. All of the acute infection cases had a good wound healing, and curing infection curing. Non of them have a relapse of infection follow up for 3-12 months by the treatment of operative debridement and irrigation of the infected wound at the first time. But all the late-developing infection cases could not curing the infection, without the removal of the implants.Conclusion ESR and CRP are the better index which can prompt the postoperative deep wound infections after spinal instrumentation. The removal of the implants is not necessary for the acute infections, but for the late-developing infections it is hard to curing the infections without the removal of the implants.