Methylene Blue Adjunct Debridement for Postoperative Spinal Infection

Abstract

: Introduction: Postoperative spine infections are a devastating surgical complication that to a poorer surgical outcome with increased morbidity and economic burden. There is no consensus set of diagnostic criteria to define a postoperative spine infection there are no well-established protocols for surgical treatment of postoperative spine infections. Successful treatment poses a significant challenge to eradicating the infection because of the presence of biofilms on metal instrumentation while the retention of implants is indicated for maintaining spinal stability. Methods: Seven patients were treated for postoperative spinal infection and we describe an adjunctive surgical approach with the application of methylene blue intraoperatively to enhance the debridement procedure to improve the outcome of the eradication of infection in retaining the spinal implant and evaluate clinical success based on the eradication of infection and infection free survival. Results: We report a series of 7 patients with deep postoperative spinal infection who were treated from January 2021 to December 2021 with a mean age of 41.14 years based on multiple surgical interventions and risk factor. All the patient were subjected to same protocols of management with methylene blue guided debridement, brushing and soaking with antibacterial cocktail solutions and followed by partial wound closure with vacuum assisted closure (VAC). The outcome of study is reporting on bacteriological study, progression of wound management and outcome of management. Conclusion: The management of postoperative spinal infection is crucial and challenging with no universally accepted protocols to establish the diagnosis and guide the treatment. Methylene blue guided debridement technique is useful as adjunct method for optimal removal of biofilms and effective debridement for total eradication of infection to improve the outcomes