Treatment of Inflammatory Infectious Complications in Spinal Surgery Using Negative Pressure
Suppuration of postoperative wounds in orthopedics and traumatology is one of the most undesirable complications. Whatever it was, by now traumatologist has a significant number of different methods of treatment for postoperative inflammatory complications. Objective of the study: to improve the outcomes and to reduce the time of treatment of inflammatory complications in spinal surgery. Materials and methods. Vast, deep infected wounds, bedsores, trophic ulcers, thermal tissue damage of varying depth are wounds whose treatment is difficult and requires special methods of closing the wound surface. An integral part of the treatment of wounds is to use various kinds of wound dressing. All dressings can be divided into occlusive and non-occlusive. An example of non-occlusive dressings are gauze bandages, which are commercially available under the trade names Tulle Gras <sup>®</sup>, Physiotulle <sup>®</sup>, Urgotul <sup>®</sup>. Gauze bandages have a structure in the form of a sieve and allow evacuation of exudates from the wound. Furthermore, mesh dressings may include active substances promoting wound healing. However, when using these dressings on wounds with lots of exudates, there remains a problem of frequent change of upper covering gauze bandage. Besides, excessive wetting of secondary dressings predisposes to secondary wound infection. Occlusive dressings, in contrast, delimit the wound from the environment. Simultaneous use of occlusive and non-occlusive dressings previously has been considered impossible. To improve the drainage of exudates from the wound, there were developed methods and devices for wound drainage using constant negative pressure. Vacuum therapy is highly effective method in wound healing, however, some problems remain unsolved. Because of the constant negative pressure on the wound surface, there are conditions for excessive drying of the wound that slows its healing. Devices and systems for the treatment of wounds using negative pressure are also produced by a number of foreign firms. The disadvantage in the use of these devices and consumables is their high cost. Finding alternative ways to implement the principles of wound therapy using negative pressure led to the possibility of a significant reduction in the cost of such treatment by modifying the method and use of the device manufactured in the Republic of Belarus (Suction Drainage Unit B-40A). We apply the method of treatment of vast wounds by a vacuum coating system and hydrogel non-occlusive mesh dressings, as a mean of preventing the drying of the wound and promoting its early healing. Simultaneous layer-by-layer wound covering with hydrogel mesh bandage is also used, as well as the system for negative pressure therapy. This method helps to eliminate the disadvantage of vacuum therapy, such as excessive drying of the wound. Conclusions. Using a combination of mesh hydrogel dressings with negative pressure therapy is a highly effective method for the treatment of suppurative complications in spinal surgery. This technique allows for the healing of surgical wounds without removing the implants and significantly reduces the time of treatment in patients with postoperative infectious complications.