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KMID : 0388720230300030103
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Journal of Korean Society of Spine Surgery
2023 Volume.30 No. 3 p.103 ~ p.108
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Double Hatchet Flap for the Reconstruction of a Posterior Neck Soft Tissue Defect due to Surgical Site Infection After Posterior Cervical Spine Surgery
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Yoon Sung-Hyuk
Park Eugene J.
Min Woo-Kie
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Abstract
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Study Design: A case report.
Objectives: To report a case of reconstruction surgery with a double hatchet flap for a posterior neck soft tissue defect due to a surgical site infection (SSI) after posterior cervical spine surgery in a 72-year-old man.
Summary of Literature Review: SSI after spinal surgery may cause devastating complications and is difficult to manage. Posterior cervical surgery is associated with a higher incidence of SSI than the posterior lumbar and anterior cervical approaches. It often requires multiple surgical debridements and long-term antibiotic use. Multiple debridements could lead to irreparable large soft tissue defects requiring reconstruction surgery with local flaps.
Materials and Methods: A 72-year-old male patient was referred to our center with tetraplegia (motor 2/5) after slipping down. The patient was diagnosed with a spinal cord injury with degenerative changes, ossification of the posterior longitudinal ligament, and multilevel cervical stenosis. The patient underwent laminectomy and posterolateral fusion via a posterior cervical approach, but starting on the third day after surgery, SSI progressed. Proper antibiotics were used and removal of the infected tissue was performed several times.
This resulted in a large soft tissue defect in the posterior neck, and reconstruction surgery using a double hatchet flap was performed.
Results: The wound healed well, without any complications.
Conclusions: A double hatchet flap can be a simple option available for defects in the posterior cervical region.
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KEYWORD
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Surgical site infection, Posterior cervical spine surgery, Reconstruction, Double hatchet flap
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