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: 2.11). 05/2011; 35(9):1415-20. DOI: 10.1007/s00264-011-1274-y
Source: PubMed


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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    • "A prompt improvement of the wound suggested continuation of treatment until foam culture was negative in 1 case and until low stable (<1000 ufc) bacterial load was achieved in the other. Similar reasons for discontinuation were reported by Lehner et al [26] and Kim et al [28]. "
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    • "Others suggested that infected wound can be successfully treated by repeated dressing changes and healing by secondary intention.15-17 Lehner et al.18 showed results of the treatment of infected orthopedic implants with negative pressure wound therapy with instillation (NPWTi). Thirty two patients were treated with this system after diagnosis of early or late implant infection. "
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