Nonhealing surgical wound

I had a bone graft from the left posterior iliac crest to C6-7 on 7/5/07. I developed a seroma and staph infection (at which time my neurosurgeon told me that all the fat in that area had turned into “soup”) and had an I&D of the seroma on 7/16/07 with a week of IV antibiotics inpatient & I&D again on 9/11/07.  I have been on IV or oral antibiotics since July 16 continuously.  I have been seen at a wound care center and they have referred me to the plastic surgeon. My wound is 1.8 cm long x 1 cm wide x 10 cm deep with tunnels, and is down to the bone.  I have had a wound VAC for 6 weeks & wound is not getting better. What treatment options are available from the plastic surgeon?

[Howard Rosenberg, MD]

There are a number of options regarding closure of the wound.  One of the first issues that may have been evaluated is whether there is infection of your bone (osteomyelitis).  Options for wound closure range from aggressive debridement and contiuned wound dressing changes to skin grafting to local flap closure.  Your plastic surgeon consultant will be able to address these options.