Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note
Background: Total 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...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-03-01
|
| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751917300725 |
| _version_ | 1818059954711429120 |
|---|---|
| author | Masao Koda, MD, PhD Takeo Furuya, MD, PhD Tomoe Kira, MD, PhD Satoshi Maki, MD, PhD Masashi Yamazaki, MD, PhD Seiji Ohtori, MD, PhD |
| author_facet | Masao Koda, MD, PhD Takeo Furuya, MD, PhD Tomoe Kira, MD, PhD Satoshi Maki, MD, PhD Masashi Yamazaki, MD, PhD Seiji Ohtori, MD, PhD |
| author_sort | Masao Koda, MD, PhD |
| collection | DOAJ |
| description | Background: Total 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 description: A 72years 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. Conclusion: Musculo-cutaneous flap is one of treatment options to fill the dead space and to control deep SSI after TES. Keywords: Total en bloc spondylectomy, Surgical site infection, Flap |
| first_indexed | 2024-12-10T13:24:44Z |
| format | Article |
| id | doaj.art-b3adba2769c5496f83e0086f5b65b662 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-10T13:24:44Z |
| publishDate | 2018-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-b3adba2769c5496f83e0086f5b65b6622022-12-22T01:47:14ZengElsevierInterdisciplinary Neurosurgery2214-75192018-03-0111810Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical noteMasao Koda, MD, PhD0Takeo Furuya, MD, PhD1Tomoe Kira, MD, PhD2Satoshi Maki, MD, PhD3Masashi Yamazaki, MD, PhD4Seiji Ohtori, MD, PhD5Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan; Corresponding author at: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Plastic and Reconstructive Surgery, Kimitsu Chuo Hospital, Kisarazu, JapanDepartment of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, JapanDepartment of Orthopedic Surgery, University of Tsukuba, Tsukuba, JapanDepartment of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, JapanBackground: Total 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 description: A 72years 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. Conclusion: Musculo-cutaneous flap is one of treatment options to fill the dead space and to control deep SSI after TES. Keywords: Total en bloc spondylectomy, Surgical site infection, Flaphttp://www.sciencedirect.com/science/article/pii/S2214751917300725 |
| spellingShingle | Masao Koda, MD, PhD Takeo Furuya, MD, PhD Tomoe Kira, MD, PhD Satoshi Maki, MD, PhD Masashi Yamazaki, MD, PhD Seiji Ohtori, MD, PhD Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note Interdisciplinary Neurosurgery |
| title | Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note |
| title_full | Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note |
| title_fullStr | Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note |
| title_full_unstemmed | Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note |
| title_short | Musculo-cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy: A technical note |
| title_sort | musculo cutaneous flap for reconstruction surgery for deep surgical site infection after total en bloc spondylectomy a technical note |
| url | http://www.sciencedirect.com/science/article/pii/S2214751917300725 |
| work_keys_str_mv | AT masaokodamdphd musculocutaneousflapforreconstructionsurgeryfordeepsurgicalsiteinfectionaftertotalenblocspondylectomyatechnicalnote AT takeofuruyamdphd musculocutaneousflapforreconstructionsurgeryfordeepsurgicalsiteinfectionaftertotalenblocspondylectomyatechnicalnote AT tomoekiramdphd musculocutaneousflapforreconstructionsurgeryfordeepsurgicalsiteinfectionaftertotalenblocspondylectomyatechnicalnote AT satoshimakimdphd musculocutaneousflapforreconstructionsurgeryfordeepsurgicalsiteinfectionaftertotalenblocspondylectomyatechnicalnote AT masashiyamazakimdphd musculocutaneousflapforreconstructionsurgeryfordeepsurgicalsiteinfectionaftertotalenblocspondylectomyatechnicalnote AT seijiohtorimdphd musculocutaneousflapforreconstructionsurgeryfordeepsurgicalsiteinfectionaftertotalenblocspondylectomyatechnicalnote |