Negative Pressure Wound Therapy with Partial Closure for Surgical Site Infections Following Spinal Surgery: A Prospective Case Series

Abstract

Background: Deep surgical site infections (SSIs) following spinal surgery remain a major postoperative challenge, particularly when associated with instrumentation and extensive soft-tissue dissection. Negative Pressure Wound Therapy (NPWT) has shown promise in managing complex wounds, but evidence on its use combined with partial wound closure in spinal SSIs is limited. This study evaluates the effectiveness of NPWT with partial closure and identifies factors influencing wound healing duration.

Methods: A prospective observational study was conducted at a tertiary care centre from July 2016 to April 2022. Sixteen patients (16–70 years) with deep SSIs and wound gaping after thoracic or lumbar open spinal surgery were included. All patients underwent surgical debridement, partial wound closure, and NPWT at –125 mmHg with dressing changes every 5–7 days. Demographic variables, wound characteristics, NPWT duration, number of dressing changes and healing time were recorded. The primary outcome was time to complete wound healing. Statistical significance was set at p ≤ 0.05.

Results: The mean patient age was 51.1 ± 12.6 years, with males comprising 69%. The mean healing time was 10.2 ± 2.8 weeks. Patients with comorbidities had significantly longer healing durations (11.4 ± 2.9 vs. 9.0 ± 1.7 weeks; p = 0.027). Larger wound size was also associated with delayed healing (p = 0.035). No major NPWT-related complications were observed.

Conclusion: NPWT with partial wound closure is a safe and effective strategy for managing deep SSIs after spinal surgery. Comorbidities and larger wound size significantly prolong healing, emphasizing the need for individualized wound management strategies.