Multidisciplinary Treatment of Persistent Nontuberculous Mycobacterial Spinal Hardware Infection with a Pedicled Superior Gluteal Artery Perforator Flap

Krystle R. Tuano; Jerry H. Yang; Christopher J. Kleck; David W. Mathes; Tae W. Chong

doi:10.1055/s-0042-1756287

Archives of Plastic Surgery, Table of Contents

CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(05): 604-607
DOI: 10.1055/s-0042-1756287

Breast/Trunk: Case Report

Multidisciplinary Treatment of Persistent Nontuberculous Mycobacterial Spinal Hardware Infection with a Pedicled Superior Gluteal Artery Perforator Flap

Authors

Krystle R. Tuano

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Jerry H. Yang

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Christopher J. Kleck

²Department of Orthopedic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
David W. Mathes

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Tae W. Chong

³Division of Plastic and Reconstructive Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia

Abstract

Nontuberculous mycobacterial hardware infections are extremely challenging to treat. Multidisciplinary care involving removal of infected hardware, thorough debridement, and durable soft tissue coverage in conjunction with antibiotic therapy is essential for successful management. This case report presents a patient with chronic mycobacterial spinal hardware infection that underwent successful treatment with aggressive serial debridements and reconstruction with a large pedicled superior gluteal artery perforator flap coverage.

Keywords

SGAP flaps - implant-associatedinfections - Mycobacterium massiliense - debridement

Full Text

References

References
1 Bryant JM, Grogono DM, Rodriguez-Rincon D. et al. Emergence and spread of a human-transmissible multidrug-resistant nontuberculous mycobacterium. Science 2016; 354 (6313): 751-757
2 Moon SH, Choi JY, Lee JH, Oh DY, Rhie JW, Ahn ST. Feasibility of a deepithelialized superior gluteal artery perforator propeller flap for various lumbosacral defects. Ann Plast Surg 2015; 74 (05) 589-593
3 Verpaele AM, Blondeel PN, Van Landuyt K. et al. The superior gluteal artery perforator flap: an additional tool in the treatment of sacral pressure sores. Br J Plast Surg 1999; 52 (05) 385-391
4 Goldstein N, St Clair JB, Kasperbauer SH, Daley CL, Lindeque B. Nontuberculous mycobacterial musculoskeletal infection cases from a Tertiary Referral Center, Colorado, USA. Emerg Infect Dis 2019; 25 (06) 1075-1083
5 Eid AJ, Berbari EF, Sia IG, Wengenack NL, Osmon DR, Razonable RR. Prosthetic joint infection due to rapidly growing mycobacteria: report of 8 cases and review of the literature. Clin Infect Dis 2007; 45 (06) 687-694
6 Park JW, Kim YS, Yoon JO. et al. Non-tuberculous mycobacterial infection of the musculoskeletal system: pattern of infection and efficacy of combined surgical/antimicrobial treatment. Bone Joint J 2014; 96-B (11) 1561-1565
7 Porrino J, Wang A, Moats A, Mulcahy H, Kani K. Prosthetic joint infections: diagnosis, management, and complications of the two-stage replacement arthroplasty. Skeletal Radiol 2020; 49 (06) 847-859
8 Piwnica-Worms W, Azoury SC, Kozak G. et al. Flap reconstruction for deep sternal wound infections: factors influencing morbidity and mortality. Ann Thorac Surg 2020; 109 (05) 1584-1590
9 Wood T, Sameem M, Avram R, Bhandari M, Petrisor B. A systematic review of early versus delayed wound closure in patients with open fractures requiring flap coverage. J Trauma Acute Care Surg 2012; 72 (04) 1078-1085