Prior to closure:
- Achieve meticulous hemostasis.
- Vancomycin powder may be applied in the wound.
Meticulously reapproximate all the muscles with numerous interrupted sutures placed 1 cm apart. This will prevent wound and muscle dehiscence as well as provide a cosmetically pleasing result.
For patients undergoing revision metastatic spine tumor surgery and/or with history of radiation, plastic surgery should perform the soft tissue reconstruction to decrease the risk of wound complications.
Drains are usually inserted via a separate stab incision.