Analysis Of The Curative Effect Of Debridement With Continuous Irrigation On The Deep Incision Infection After Thoracolumbar Posterior Fixation

Objective: To explore the curative effect of debridement with continuous irrigating on the deep incision infection after thoracolumbar posterior fixation.Methods: A retrospective analysis was performed on 19 patients with deep incision infection after thoracolumbar spine internal fixation at the Department of Orthopaedics,First Affiliated Hospital of China Medical University from June 2013 to August 2017.All cases underwent thorough debridement and joint surgery.The use of sensitive antibiotics was divided into experimental group(continuous debridement and continuous irrigation and drainage group)in 11 cases and control group(debridement and indwelling drainage group after debridement)in 8 cases according to different drainage methods.Age and initial surgery were compared between the two groups.The preoperative general data including the length of the internal fixation segment,post-infection symptoms,and the level of inflammatory markers,etc.,were determined according to whether the symptoms of infection after debridement were eliminated,the trend of inflammation indicators,and the results of bacterial culture of the secretions to determine the status of wound infection control.Follow-up Macnab efficacy evaluation criteria scores and radiological review of retained internal fixation patients were used to determine postoperative efficacy and recurrence of infection.The postoperative infection symptom elimination time,postoperative antibiotic application time,and postoperative curative effect were compared between the two groups.Scores and other indicators to study debridement and continuous irrigation and drainage for deep incision infection after thoracolumbar spinal internal fixation Therapeutic effect.Results: There was no significant difference in the preoperative general data between the experimental group(continuous debridement and continuous drainage group)and the control group(debridement group after debridement)(P > 0.05).Nineteen patients had primary healed wounds after surgical infection,and the local infection symptoms such as thoracolumbar pain were relieved.The combination of intravenous antibiotics and bacterial culture was negative,and the body temperature and inflammatory index fell within the normal range or near normal.The infection was obtained.Effective control.The elimination time of postoperative infection symptoms and postoperative antibiotic use time in the experimental group(debridement and drainage group after debridement)were shorter than those in the control group(debridement group after debridement),and the differences were statistically significant(P<0.05).There was no significant difference in postoperative efficacy between the two groups(P>0.05).After 6 to 51 months of follow-up,no cases of recurrence of infection were found,and no internal fixation loosening or other adverse reactions were found after re-examination of postoperative imaging data of retained internal fixation.Conclusion: Debridement and continuous drainage of debridement after drainage than a simple drainage can quickly restore the infection symptoms and reduce the incision infection treatment time,is the treatment of thoracolumbar posterior fixation of effective treatment of deep infection.