Use of biological tissue matrix in postneurosurgical posterior trunk reconstruction is associated with higher wound complication rates

Devin O'Brien-Coon, Nicholas A. Calotta, Justin M. Broyles, Justin Michael Sacks

Research output: Contribution to journalArticle

Abstract

Background: Patients undergoing neurosurgical spine surgery for spinal tumors are increasingly undergoing soft-tissue reconstruction involving the use of biological tissue matrices. There are limited data available on the safety of these devices in posterior trunk reconstruction. Methods: A cohort study of patients undergoing oncologic spine surgery with subsequent plastic surgery soft-tissue reconstruction from 2002 to 2014 was conducted. Demographic, medical, and surgical variables were recorded. The primary outcome variable was development of a postoperative wound complication. Secondary outcome variables were specific complications, including infection, seroma, hematoma, dehiscence, and cerebrospinal fluid leak. The predictor variable was the presence or absence of biological matrix at the reconstruction site. Results: A total of 293 cases in 260 patients were included in this study. The cohorts were similar with regard to demographic, medical, and surgical variables. The incidence of all-cause wound complications in patients receiving biological matrix for reconstruction was 49.2 percent, whereas the all-cause complication rate for patients not receiving the matrix was 31.7 percent (p = 0.010). The rates of infection (34.9 percent versus 20.9 percent) and seroma (19.0 percent versus 10.0 percent) were also increased in patients receiving biological matrix. In multivariate analysis, biological matrix use remained a predictor of wound complications (p = 0.045), infection (p = 0.011), and seroma (p = 0.047). Conclusions: The authors identified an increased risk of infection and seroma with the use of biological tissue matrix in posterior trunk reconstruction. Careful consideration of the risks and benefits of using these devices in this patient population is warranted.

Original languageEnglish (US)
Pages (from-to)104e-110e
JournalPlastic and Reconstructive Surgery
Volume138
Issue number1
DOIs
StatePublished - Jul 1 2016

Fingerprint

Seroma
Wounds and Injuries
Infection
Spine
Demography
Protective Devices
Plastic Surgery
Hematoma
Cohort Studies
Multivariate Analysis
Equipment and Supplies
Incidence
Population
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Use of biological tissue matrix in postneurosurgical posterior trunk reconstruction is associated with higher wound complication rates. / O'Brien-Coon, Devin; Calotta, Nicholas A.; Broyles, Justin M.; Sacks, Justin Michael.

In: Plastic and Reconstructive Surgery, Vol. 138, No. 1, 01.07.2016, p. 104e-110e.

Research output: Contribution to journalArticle

@article{47f5a08cb59b481daebf3d3f391e482f,
title = "Use of biological tissue matrix in postneurosurgical posterior trunk reconstruction is associated with higher wound complication rates",
abstract = "Background: Patients undergoing neurosurgical spine surgery for spinal tumors are increasingly undergoing soft-tissue reconstruction involving the use of biological tissue matrices. There are limited data available on the safety of these devices in posterior trunk reconstruction. Methods: A cohort study of patients undergoing oncologic spine surgery with subsequent plastic surgery soft-tissue reconstruction from 2002 to 2014 was conducted. Demographic, medical, and surgical variables were recorded. The primary outcome variable was development of a postoperative wound complication. Secondary outcome variables were specific complications, including infection, seroma, hematoma, dehiscence, and cerebrospinal fluid leak. The predictor variable was the presence or absence of biological matrix at the reconstruction site. Results: A total of 293 cases in 260 patients were included in this study. The cohorts were similar with regard to demographic, medical, and surgical variables. The incidence of all-cause wound complications in patients receiving biological matrix for reconstruction was 49.2 percent, whereas the all-cause complication rate for patients not receiving the matrix was 31.7 percent (p = 0.010). The rates of infection (34.9 percent versus 20.9 percent) and seroma (19.0 percent versus 10.0 percent) were also increased in patients receiving biological matrix. In multivariate analysis, biological matrix use remained a predictor of wound complications (p = 0.045), infection (p = 0.011), and seroma (p = 0.047). Conclusions: The authors identified an increased risk of infection and seroma with the use of biological tissue matrix in posterior trunk reconstruction. Careful consideration of the risks and benefits of using these devices in this patient population is warranted.",
author = "Devin O'Brien-Coon and Calotta, {Nicholas A.} and Broyles, {Justin M.} and Sacks, {Justin Michael}",
year = "2016",
month = "7",
day = "1",
doi = "10.1097/PRS.0000000000002244",
language = "English (US)",
volume = "138",
pages = "104e--110e",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Use of biological tissue matrix in postneurosurgical posterior trunk reconstruction is associated with higher wound complication rates

AU - O'Brien-Coon, Devin

AU - Calotta, Nicholas A.

AU - Broyles, Justin M.

AU - Sacks, Justin Michael

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: Patients undergoing neurosurgical spine surgery for spinal tumors are increasingly undergoing soft-tissue reconstruction involving the use of biological tissue matrices. There are limited data available on the safety of these devices in posterior trunk reconstruction. Methods: A cohort study of patients undergoing oncologic spine surgery with subsequent plastic surgery soft-tissue reconstruction from 2002 to 2014 was conducted. Demographic, medical, and surgical variables were recorded. The primary outcome variable was development of a postoperative wound complication. Secondary outcome variables were specific complications, including infection, seroma, hematoma, dehiscence, and cerebrospinal fluid leak. The predictor variable was the presence or absence of biological matrix at the reconstruction site. Results: A total of 293 cases in 260 patients were included in this study. The cohorts were similar with regard to demographic, medical, and surgical variables. The incidence of all-cause wound complications in patients receiving biological matrix for reconstruction was 49.2 percent, whereas the all-cause complication rate for patients not receiving the matrix was 31.7 percent (p = 0.010). The rates of infection (34.9 percent versus 20.9 percent) and seroma (19.0 percent versus 10.0 percent) were also increased in patients receiving biological matrix. In multivariate analysis, biological matrix use remained a predictor of wound complications (p = 0.045), infection (p = 0.011), and seroma (p = 0.047). Conclusions: The authors identified an increased risk of infection and seroma with the use of biological tissue matrix in posterior trunk reconstruction. Careful consideration of the risks and benefits of using these devices in this patient population is warranted.

AB - Background: Patients undergoing neurosurgical spine surgery for spinal tumors are increasingly undergoing soft-tissue reconstruction involving the use of biological tissue matrices. There are limited data available on the safety of these devices in posterior trunk reconstruction. Methods: A cohort study of patients undergoing oncologic spine surgery with subsequent plastic surgery soft-tissue reconstruction from 2002 to 2014 was conducted. Demographic, medical, and surgical variables were recorded. The primary outcome variable was development of a postoperative wound complication. Secondary outcome variables were specific complications, including infection, seroma, hematoma, dehiscence, and cerebrospinal fluid leak. The predictor variable was the presence or absence of biological matrix at the reconstruction site. Results: A total of 293 cases in 260 patients were included in this study. The cohorts were similar with regard to demographic, medical, and surgical variables. The incidence of all-cause wound complications in patients receiving biological matrix for reconstruction was 49.2 percent, whereas the all-cause complication rate for patients not receiving the matrix was 31.7 percent (p = 0.010). The rates of infection (34.9 percent versus 20.9 percent) and seroma (19.0 percent versus 10.0 percent) were also increased in patients receiving biological matrix. In multivariate analysis, biological matrix use remained a predictor of wound complications (p = 0.045), infection (p = 0.011), and seroma (p = 0.047). Conclusions: The authors identified an increased risk of infection and seroma with the use of biological tissue matrix in posterior trunk reconstruction. Careful consideration of the risks and benefits of using these devices in this patient population is warranted.

UR - http://www.scopus.com/inward/record.url?scp=84976340253&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976340253&partnerID=8YFLogxK

U2 - 10.1097/PRS.0000000000002244

DO - 10.1097/PRS.0000000000002244

M3 - Article

C2 - 27348672

AN - SCOPUS:84976340253

VL - 138

SP - 104e-110e

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 1

ER -