OBJECTIVES: to describe the authors' experience in managing deep wound infection after surgical procedure on the lumbar spine, as well as to evaluate the clinical and functional long-term course of these patients. METHODS: prospective cohort study, comprising patients who presented deep infection of the surgical wound between, carried out in January 1997 till January 2009. All the patients were submitted to surgical revision, collection of material for a microbiological examination, exhaustive washing, debridement, implementation of a continuous washing system, primary suturing of the wound and treatment with antibiotics. The instrumentation was not removed from any patient. The patients were evaluated radiologically, clinically and functionally during the follow-up. Paired analyses were performed by means of Wilcoxon test. RESULTS: the incidence of infection was 3.1% (15/485). The most prevalent etiological agent was Staphylococcus aureus. All surgical procedures obtained consolidation. In a mean follow-up of 47.6 months, changes were seen in the numerical scale pain scores (p=0.001), Oswestry Disability Index (p=0.017) and physical component of SF-36 (p=0.036). In the final evaluation, 64.2% of the patients (9/14) presented minimal disability, and 35.8% (5/14), moderate disability. CONCLUSION: Aggressive treatment of postoperative infections after spinal lumbar fusion avoids removal of the instrumentation and allows the maintenance of the vertebral stability. Despite the complications, the patients presented improvement with regard to pain, functional capacity and preoperative quality of life.
Surgical wound infection; Spine; Postoperative complications; Orthopedic procedures
