Negative Pressure Wound Therapy - A Multi-Centered Randomized Control Trial

Time for wound closure

This will be measured intra-operatively in the operating room from the beginning of deep wound closure till complete skin closure either with standard treatment or by NPWT. Though this outcome measure may not appear to have much value as these surgeries are of a long duration, we considered it important from the surgeon's perspective.

Time frame: intraoperatively

Cosmetic results

(Hollander wound evaluation scale): This is a validated cosmetic scoring system \[8\], which gives a score from 0 to 6. The score addresses six clinical variables: step off borders, contour irregularities, scar width, edge inversion, excessive inflammation, and overall cosmetic appearance. Each of these categories is graded on a 0- or 1-point scale where a score of 6 is considered optimal. At 12 weeks post-op follow-up, assessment of the scar will be carried out by an independent investigator who will be blinded to which treatment group the patient belongs to.

Time frame: 12 weeks post op

Caregiver/parental satisfaction

This will analyzed on a visual analog scale (VAS)

Time frame: 12 weeks post op

Wound dehiscence

Any gaping of the spinal wound \> 5cm exposing subcutaneous tissue or deeper planes will be considered as indicative of wound dehiscence. This will be looked for at the 5th post- operative day during dressing change till 14 days post-op.

Time frame: psot op day 5 to discharge

Foreign body reaction

Any evidence of foreign body reaction will be looked for at the two week mark and at 12 weeks post-op follow up. The presence of swelling under the wound over the suture or NPWT site in the absence of fever, significant redness and tenderness will be indicative of foreign body reaction.

Time frame: 12 weeks post op