Prophylactic Muscle Flaps Decrease Wound Complication Rates in Patients with Oncologic Spine Disease.

dc.contributor.author

Dalton, Tara

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Darner, Grant

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McCray, Edwin

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Price, Meghan

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Baƫta, Cesar

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Erickson, Melissa

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Karikari, Isaac O

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Abd-El-Barr, Muhammad M

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Goodwin, C Rory

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Brown, David A

dc.date.accessioned

2024-08-14T15:08:58Z

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2024-08-14T15:08:58Z

dc.date.issued

2024-01

dc.description.abstract

Background

Patients with oncologic spine disease face a high systemic illness burden and often require surgical intervention to alleviate pain and maintain spine stability. Wound healing complications are the most common reason for reoperation in this population and are known to impact quality of life and initiation of adjuvant therapy. Prophylactic muscle flap (MF) closure is known to reduce wound healing complications in high-risk patients; however, the efficacy in oncologic spine patients is not well established.

Methods

A collaboration at our institution presented an opportunity to study the outcomes of prophylactic MF closure. The authors performed a retrospective cohort study of patients who underwent MF closure versus a cohort who underwent non-MF closure in the preceding time. Demographic and baseline health data were collected, as were postoperative wound complication data.

Results

A total of 166 patients were enrolled, including 83 patients in the MF cohort and 83 control patients. Patients in the MF group were more likely to smoke ( P = 0.005) and had a higher incidence of prior spine irradiation ( P = 0.002). Postoperatively, five patients (6%) in the MF group developed wound complications, compared with 14 patients (17%) in the control group ( P = 0.028). The most common overall complication was wound dehiscence requiring conservative therapy, which occurred in six control patients (7%) and one MF patient (1%) ( P = 0.053).

Conclusions

Prophylactic MF closure during oncologic spine surgery significantly reduces the wound complication rate. Future studies should examine the precise patient population that stands to benefit most from this intervention.

Clinical question/level of evidence

Therapeutic, III.
dc.identifier

00006534-202401000-00042

dc.identifier.issn

0032-1052

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1529-4242

dc.identifier.uri

https://hdl.handle.net/10161/31363

dc.language

eng

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Ovid Technologies (Wolters Kluwer Health)

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Plastic and reconstructive surgery

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10.1097/prs.0000000000010568

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https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Muscles

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Humans

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Surgical Wound Infection

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Spinal Diseases

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Postoperative Complications

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Treatment Outcome

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Retrospective Studies

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Quality of Life

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Plastic Surgery Procedures

dc.title

Prophylactic Muscle Flaps Decrease Wound Complication Rates in Patients with Oncologic Spine Disease.

dc.type

Journal article

duke.contributor.orcid

Abd-El-Barr, Muhammad M|0000-0001-7151-2861

duke.contributor.orcid

Goodwin, C Rory|0000-0002-6540-2751

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Brown, David A|0000-0002-0616-0617

pubs.begin-page

221

pubs.end-page

231

pubs.issue

1

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Orthopaedic Surgery

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Radiation Oncology

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Surgery

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Surgery, Plastic, Maxillofacial, and Oral Surgery

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Duke Cancer Institute

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Neurosurgery

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Duke Regeneration Center

pubs.publication-status

Published

pubs.volume

153

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