MODIFICATION OF THE NEGATIVE PRESSURE THERAPY TECHNIQUE FOR TREATMENT OF WOUND INFECTION AFTER SPINAL SURGERY

MODIFICAÇÃO DA TÉCNICA DE TERAPIA DE PRESSÃO NEGATIVA PARA TRATAMENTO DE INFECÇÃO DE FERIDA DEPOIS DE CIRURGIA DE COLUNA

MODIFICACIÓN DE LA TÉCNICA DE TERAPIA DE PRESIÓN NEGATIVA PARA TRATAMIENTO DE INFECCIÓN DE LA HERIDA DESPUÉS DE CIRUGÍA DE COLUMNA

ABSTRACT

Objective  To describe the indications and contraindications of negative pressure assisted wound therapy as well as a modification to the negative pressure technique that has been shown to shorten the number of changes of dressings and hospital stay with the early closure of the wound.

Methods  A review of the existing literature in the databases OVID, PubMed, Cochrane and Medigraphic was carried out in relation to the pressure-assisted closure of wounds. This is a non-invasive and active healing system that uses localized and controlled negative pressure, which consists of a specialized dressing that includes reticulated foam that removes the exudates through a tube to an airtight container. This set forms microdeformations in the wound bed, which are known to cause an important increase in fibroblastic migration and consequently of higher quality tissue, granulation tissue formation and angiogenesis.

Results  It was found that this method shortens the number of days of hospital stay. The technique describes the primary closure of the wound after intense cleansing and debridement of the non-viable tissue and signs of infection.

Conclusions  Negative pressure wound therapy is effective for the treatment of deep infections in postsurgical spinal wound, with average time of use of 1 to 4 weeks in the most severe cases. Level of evidence IV; Case Series.

Negative-Pressure Wound Therapy; Infection; Spine