This is a prospective randomized study evaluating the use of a prophylactic incision wound vac dressing, applied in the OR, on patients undergoing posterior spine surgery with a BMI>35. Patients are randomized in the operating room to normal postoperative dressing vs. vac dressing. The vac dressing would be left on for 72 hours postoperatively. In the interim, the patients' postoperative care can proceed as usual. Our primary outcomes will be antibiotics or return trip needed to the operating room for wound related complications.

The patients only intervention would be the application of an incisional wound vac. The will be no change in the patients postoperative protocol otherwise. This procedure is noninvasive.

Inclusion Criteria:

• Be scheduled to have posterior spine surgery (inpatient procedures only).
• Have a BMI greater than or equal to 35.

Exclusion Criteria:

• BMI less than 35
• Previous spine infection
• Intraoperative dural tear

28 participants' data (2 from elsewhere and 26 from Michigan) was lost and their baseline data is not included. The individual who began in the standard dressing group and then subsequently participated in the wound vac group is only represented in the standard dressing group for baseline characteristics analysis.

6 weeks after surgery

The only adverse events that were collected were extended antibiotic use and rehospitalization. So the 0s listed in "other adverse events" is simply a statement of what data was collected, but not an assurance that no non-serious adverse events occurred.

Systematic assessment was performed simply by a records review pulling for those two items: extended antibiotic use and rehospitalization.

This small study was intended to be a pilot. Without a larger population, results should not be seen as generalizable.