First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: A clinical observational study

Department of Orthopedic Oncology and Septic Orthopedic Surgery, Orthopedic University Hospital, Heidelberg, Germany.
International Orthopaedics (Impact Factor: 2.02). 05/2011; 35(9):1415-20. DOI: 10.1007/s00264-011-1274-y
Source: PubMed

ABSTRACT Infections associated with orthopaedic implants remain a serious complication. The main objective in acute infection control is component retention, whereas this option is usually not considered for chronic infections.
This multi-centre prospective, non-randomised observational study investigated one possible treatment option for implant retention in combination with negative pressure wound therapy with instillation (NPWTi). Thirty-two patients with an infected orthopaedic implant were analysed. Twenty-two patients had an acute infection (< 8 weeks after implantation) and ten patients had a chronic infection (> 8 weeks and < 36 weeks after implant placement). Polyhexanide was used as the instillation solution in 31 of the 32 cases.
Nineteen patients (86.4%) with an acute infection and eight patients (80%) with a chronic infection retained their implant at 4-6 months follow-up after treatment.
Our study showed that NPWTi can be used as adjunctive therapy for salvage of acutely infected orthopaedic implants and may even be considered for early chronically infected implants.

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    • "Once a mature biofilm is established, conventional antibiotic-based therapies are not efficacious. Under such circumstances, surgical replacement of the infected implant would be the only choice, which results in severe patient distress and huge costs [2]. Thus, development of effective strategies to combat implant-associated infections is urgently needed. "
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