Management of a purulent-necrotic surgical site infection following instrumented scoliosis correction: a case report

Purulent–necrotic infections of the surgical wound following instrumented correction of thoracolumbar scoliosis remain among the most serious complications in spinal surgery, because they often require implant removal, prolonged disability, and recurrence. In adult patients undergoing surgery at a mature age for scoliosis deformity (traditionally corrected in childhood or adolescence), such complications occur less frequently and have specific clinical features. The presented clinical case of a 46-year-old patient with a postoperative wound infection in the form of purulent–necrotic phlegmon after correction of the thoracic spine illustrates successful preservation of spinal instrumentation after six revision and debridement procedures, followed by installation of a vacuum-assisted closure (VAC) system and two VAC system replacements with complete wound closure. This case suggests the potential value of repeated surgical debridement combined with vacuum-assisted therapy as an effective approach to implant salvage even in severe purulent-necrotic processes, which is of significant importance for clinical practice.