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Multiple Day Drainage When Using Bone Morphogenic Protein for Long-Segment Thoraco-Lumbar Fusions is Associated with Low Rates of Wound Complications.
MedLine Citation:
PMID:  22929109     Owner:  NLM     Status:  Publisher    
OBJECITVE: Concerns over increased wound complication rates have been raised when bone morphogenic protein (BMP) is employed as an adjunct for fusion in spinal surgery. In this study we evaluated 50 consecutive patients undergoing long-segment thoraco-lumbar spinal fusions with BMP to assess drain output and the rates of reoperation for infection or seroma. METHODS: Inclusion criteria included: patients undergoing 4 or more levels of posterior instrumented thoracolumbar fusion, use of BMP, age >18 years, and a perioperative followup of ≥ 60 days. Drain output, length of time of drainage, and need for reoperation for wound seroma or infection were reviewed. RESULTS: 87 patients met inclusion criteria and had a mean age of 58.5 years (SD 16, range 20- 81). The average number of levels instrumented and arthrodesed with BMP was 9.2 (SD 3.7; range 4-18), and the average dose of BMP used was 31.2 mg (SD 9.6, range 12-48) or 2.6 large sponges. Patients required drainage for a mean of 4.9 days (SD 1.3, range 3-9). The average total output was 1923cc (SD 865, range 530-4310cc). The wound infection rate was 2.3% (2 cases of deep wound infection that required reoperation). There was one (1.1%) hematoma, and one (1.1%) sterile seroma, both requiring evacuation. No other wound complications were noted. CONCLUSIONS: Use of BMP for long-segment posterior thoraco-lumbar fusions may be associated with significant drain output, requiring multiple days of drainage. However, when drained adequately, infections and seromas occur infrequently.
Dwight Saulle; Kai-Ming G Fu; Christopher I Shaffrey; Justin S Smith
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-25
Journal Detail:
Title:  World neurosurgery     Volume:  -     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
University of Virginia, Department of Neurosurgery, Charlottesville, VA.
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