Postoperative synergistic gangrene after spinal fusion.

Abstract

STUDY DESIGN:

A case of synergistic necrotizing gangrenous fasciitis after spinal surgery is reported.

OBJECTIVES:

To describe this unusual complication, explain the rationale of treatment, and increase awareness of this serious postoperative complication.

SUMMARY OF BACKGROUND DATA:

Although several cases of postoperative synergistic necrotizing fasciitis have been reported, there are no previously reported cases of this condition after spinal surgery.

METHODS:

A rapidly progressive necrotizing spinal wound infection after fusion for degenerative disc disease was treated in a 39-year-old man.

RESULTS:

The infection was successfully treated with serial debridements, appropriate antibiotics, and hyperbaric wound oxygenation.

CONCLUSIONS:

The authors suggest adherence to the fundamental principles of treatment including radical surgical debridement and appropriate antibiosis for necrotizing gangrene after spinal surgery. In evaluation of aggressive spinal wound infections, diagnosis of synergistic necrotizing fasciitis should be kept in mind. Although hyperbaric wound oxygenation was implemented as an adjunct and appeared to aid in controlling the infection, its effect on outcome is not clear.

• Authors: C P Kauffman, C M Bono, P P Vessa, K G Swan
• Journal: Spine (Spine (Phila Pa 1976)) Vol. 25 Issue 13 Pg. 1729-32 (Jul 01 2000) ISSN: 0362-2436 [Print] United States
• PMID: 10870152 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Back Pain (microbiology, surgery)
• Debridement
• Diskectomy
• Escherichia coli Infections (drug therapy)
• Fasciitis, Necrotizing (therapy)
• Gangrene (therapy)
• Humans
• Hyperbaric Oxygenation
• Male
• Postoperative Complications (microbiology)
• Spinal Fusion
• Streptococcal Infections (drug therapy)