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Semin Plast Surg 2021; 35(01): 003-009
DOI: 10.1055/s-0041-1722852
Review Article

The Historical Role of the Plastic Surgeon in Spine Reconstruction

Annie Do
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, California
,
Matthew J. Davis
2   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
3   Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
,
Amjed Abu-Ghname
2   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
3   Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
,
Sebastian J. Winocour
2   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Edward M. Reece
2   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
3   Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas
,
Scott Holmes
4   Department of Surgery, Baylor College of Medicine, Houston, Texas
,
David S. Xu
5   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
Alexander E. Ropper
5   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
,
Scott L. Hansen
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California, San Francisco, California
› Author Affiliations Funding None.
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Abstract

Wound complications occur in up to 19% of patients undergoing complex spine surgery. The role of the plastic surgeon in complex and redo spine surgery is important and evolving. Classically, plastic surgeons have been involved in the management of patients who develop wound complications following surgery. This involves reconstruction of posterior trunk defects with locoregional fasciocutaneous, muscle, and free tissue transfers. There has also been an increasing role for plastic surgeons to become involved in prophylactic closures of complex and/or redo spine surgeries for high-risk populations. Identification of patients with comorbidities and likelihood for multiple reoperations who are prophylactically treated with complex closure with or without local muscle flaps could significantly decrease the postoperative wound complications.

Keywords

spine surgery - complications - plastic surgery - complex closure


Publication History

Article published online:
10 May 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Verma R, Siddiqi F, Lipetz JS, Samujh C, Silber JS. Advances in technology and surgical technique in spine surgery. Am J Orthop 2007; 36 (08) 413-417
    PubMedGoogle Scholar
  • 2 Reeg SE. A review of comorbidities and spinal surgery. Clin Orthop Relat Res 2001; 384 (384) 101-109
    CrossrefPubMedGoogle Scholar
  • 3 Maruo K, Berven SH. Outcome and treatment of postoperative spine surgical site infections: predictors of treatment success and failure. J Orthop Sci 2014; 19 (03) 398-404
    CrossrefPubMedGoogle Scholar
  • 4 Cohen LE, Fullerton N, Mundy LR. et al. Optimizing successful outcomes in complex spine reconstruction using local muscle flaps. Plast Reconstr Surg 2016; 137 (01) 295-301
    CrossrefPubMedGoogle Scholar
  • 5 Nasser R, Yadla S, Maltenfort MG. et al. Complications in spine surgery. J Neurosurg Spine 2010; 13 (02) 144-157
    CrossrefPubMedGoogle Scholar
  • 6 Saint-Cyr M, Nikolis A, Moumdjian R. et al. Paraspinous muscle flaps for the treatment and prevention of cerebrospinal fluid fistulas in neurosurgery. Spine 2003; 28 (05) E86-E92
    CrossrefPubMedGoogle Scholar
  • 7 Mathes DW, Thornton JF, Rohrich RJ. Management of posterior trunk defects. Plast Reconstr Surg 2006; 118 (03) 73e-83e
    CrossrefPubMedGoogle Scholar
  • 8 Lee R, Beder D, Street J. et al. The use of vacuum-assisted closure in spinal wound infections with or without exposed dura. Eur Spine J 2018; 27 (10) 2536-2542
    CrossrefPubMedGoogle Scholar
  • 9 Chen K, Lin JT, Sun SB, Lin J, Kong JZ, Tian NF. Vacuum-assisted closure combined with a closed suction irrigation system for treating postoperative wound infections following posterior spinal internal fixation. J Orthop Surg Res 2018; 13 (01) 321
    CrossrefPubMedGoogle Scholar
  • 10 Eshima I, Mathes SJ, Paty P. Comparison of the intracellular bacterial killing activity of leukocytes in musculocutaneous and random-pattern flaps. Plast Reconstr Surg 1990; 86 (03) 541-547
    CrossrefPubMedGoogle Scholar
  • 11 Calderon W, Chang N, Mathes SJ. Comparison of the effect of bacterial inoculation in musculocutaneous and fasciocutaneous flaps. Plast Reconstr Surg 1986; 77 (05) 785-794
    CrossrefPubMedGoogle Scholar
  • 12 Mathes SJ, Nahai F. Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg 1981; 67 (02) 177-187
    CrossrefPubMedGoogle Scholar
  • 13 Mericli AF, Tarola NA, Moore Jr JH, Copit SE, Fox IV JW, Tuma GA. Paraspinous muscle flap reconstruction of complex midline back wounds: risk factors and postreconstruction complications. Ann Plast Surg 2010; 65 (02) 219-224
    CrossrefPubMedGoogle Scholar
  • 14 Bostwick III J, Scheflan M, Nahai F, Jurkiewicz MJ. The “reverse” latissimus dorsi muscle and musculocutaneous flap: anatomical and clinical considerations. Plast Reconstr Surg 1980; 65 (04) 395-399
    CrossrefPubMedGoogle Scholar
  • 15 Mathes SJ, Stevenson TR. Reconstruction of posterior neck and skull with vertical trapezius musculocutaneous flap. Am J Surg 1988; 156 (04) 248-251
    CrossrefPubMedGoogle Scholar
  • 16 Disa JJ, Smith AW, Bilsky MH. Management of radiated reoperative wounds of the cervicothoracic spine: the role of the trapezius turnover flap. Ann Plast Surg 2001; 47 (04) 394-397
    CrossrefPubMedGoogle Scholar
  • 17 Kim JE, Pang J, Christensen JM. et al. Soft-tissue reconstruction after total en bloc sacrectomy. J Neurosurg Spine 2015; 22 (06) 571-581
    CrossrefPubMedGoogle Scholar
  • 18 Junge K, Krones CJ, Rosch R, Fackeldey V, Schumpelick V. Mesh reconstruction preventing sacral herniation. Hernia 2003; 7 (04) 224-226
    CrossrefPubMedGoogle Scholar
  • 19 Sambri A, Gasbarrini A, Cialdella S, De Iaco P, Boriani S. Pedicled omental flaps in the treatment of complex spinal wounds after en bloc resection of spine tumors. J Plast Reconstr Aesthet Surg 2017; 70 (09) 1267-1271
    CrossrefPubMedGoogle Scholar
  • 20 Matschke J, Armbruster R, Reeps C, Weitz J, Dragu A. AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient. World J Surg Oncol 2019; 17 (01) 154
    CrossrefPubMedGoogle Scholar
  • 21 Chieng LO, Hubbard Z, Salgado CJ, Levi AD, Chim H. Reconstruction of open wounds as a complication of spinal surgery with flaps: a systematic review. Neurosurg Focus 2015; 39 (04) E17
    CrossrefPubMedGoogle Scholar
  • 22 Horch RE. Incisional negative pressure wound therapy for high-risk wounds. J Wound Care 2015; 24 (4, Suppl): 21-28
    CrossrefPubMedGoogle Scholar
  • 23 Dyck BA, Bailey CS, Steyn C. et al. Use of incisional vacuum-assisted closure in the prevention of postoperative infection in high-risk patients who underwent spine surgery: a proof-of-concept study. J Neurosurg Spine 2019; 31 (03) 430-439
    CrossrefPubMedGoogle Scholar
  • 24 Adogwa O, Fatemi P, Perez E. et al. Negative pressure wound therapy reduces incidence of postoperative wound infection and dehiscence after long-segment thoracolumbar spinal fusion: a single institutional experience. Spine J 2014; 14 (12) 2911-2917
    CrossrefPubMedGoogle Scholar