Challenging the Dogma of Dead Space Obliteration With Muscle Flaps in Deep Spinal Surgical Site Infections

The MDICAP flap is a good alternative to muscle flaps in reconstructive surgery for complex posterior midline defects caused by a deep SSI after spinal surgery. Postoperative imaging showed no dead space with the use of MDICAP flaps. All patients had an uneventful postoperative course with no recurrent infections. This challenges the dogmata of (1) the need for muscle flaps in such reconstruction and (2) the obligate need for dead space obliteration at the time of operation.