Journal Article Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note

Koda, Masao  ,  Furuya, Takeo  ,  Kira, Tomoe  ,  Maki, Satoshi  ,  Yamazaki, Masashi  ,  Ohtori, Seiji

11pp.8 - 10 , 2018-03 , Elsevier
BackgroundTotal en bloc spondylectomy (TES) is potential radical resection surgery for spinal tumors. Surgical procedure of TES includes extremely wide detachment of surrounding soft tissue from pathological vertebra, resulting in impairment of blood supply. Moreover, massive dead space inevitably is made after vertebral body resection. Therefore deep surgical site infection (SSI) after TES could be intractable. To date, suitable treatment for deep SSI after TES has not been established.Case descriptionA 72 years old man underwent TES of 12th thoracic level via single posterior approach for primary leiomyosarcoma. Postoperative additional irradiation was performed. One year after surgery, late infection around the cage occurred. We removed the cage followed by autologous iliac bone grafting, we treat the wound by open therapy and daily irrigation, followed by negative pressure wound therapy. Four-month later, we performed musculo-cutaneous flap using latissimus dorsi muscle with plastic surgeons. At the follow-up visit one year after flap surgery, no evidence of recurrence of infection was observed.ConclusionMusculo-cutaneous flap is one of treatment options to fill the dead space and to control deep SSI after TES.

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