退行性脊柱侧凸后路三维矫形术后伤口感染的处理

 目的 探讨退行性脊柱侧凸后路三维矫形术后伤口感染的诊断和处理方法.方法 回顾性分析10例退行性脊柱侧凸后路三维矫形术后伤口感染患者的治疗经过.2例为浅层伤口感染,采用单纯清创换药;8例为深部伤口迟发性感染,其中5例采用伤口清创,置管冲洗引流;3例植骨已获得融合的患者行内置物取出、病灶清除、灌洗引流术,Ⅰ期关闭切口.结果 10例患者中的8例经过上述治疗后获得治愈,2例深部伤口感染患者经伤口清创、置管冲洗引流治疗,分别于治疗后4个月、8个月再次发生深部伤口感染;复查X线片,植骨均获得融合,给予内置物取出、病灶清除、灌洗引流术,Ⅰ期关闭切口,深部感染获得痊愈.结论 退行性脊柱侧凸后路三维矫形术后伤口感染是一种严重的并发症,伤口浅层感染可经过单纯清创换药获得治愈;对于深部伤口迟发性感染,伤口清创,置管冲洗引流是一种有效的方法,可为早期感染植骨融合赢得时间;内固定取出为非必要条件.

Management of wound infection after posterior pedicle screws correction surgery of degenerative scoliosis

Objective To study the diagnosis and treatment of wound infection after degenerative scoliosis of posterior pedicle screws correction technique.Methods The management of 10 patients with wound infection after posterior pedicle screws correction of degenerative scoliosis was retrospectively analyzed. Two cases had superficial wound infection and received simple debridement and dressing change. Eight cases had deep delayed wound infection, of whom 5 underwent debridement and irrigation- suction, and 3 proved to have bone graft union and underwent removal of implant and primary suture of incision.Results The wound healed after treatment in 8 of 10 cases, infection reoccurred in 2 cases of deep delayed wound infection 4 months and 8 months after debfidement and irrigation- suction. Wound healed in all the patients who had radiographically confmned bone graft union and underwent removal of implant, debridement, irrigation - suction, and primary suture of incision. Conclusions Wound infection is a severe comphcation after posterior pedicle screws correction of degenerative scoliosis. Superficial infection can be healed after simple debridement and dressing changie. Debridement and irrigation- suction is an effective method, facilitating bone graft union. Removal of implant is not indispensable.