Article

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.

0 Followers
 · 
121 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to evaluate the use of incisional negative pressure wound therapy (iNPWT) in wound healing after femoral neck fracture (FNF) treated with hip hemiarthroplasty (HA) and its influence on postoperative seromas, wound secretion, as well as time and material consumption for dressing changes. The study is a prospective randomised evaluation of iNPWT in patients with large surgical wounds after FNF. Patients were randomised either to be treated by iNPWT (group A) or a standard wound dressing (group B). Follow-up included ultrasound measurements of seroma volumes on postoperative days 5 and 10, duration of wound secretion, and time and material spent for wound dressing changes. For comparison of the means, we used the t-test for independent samples, P > 0·05 was considered significant. There were 21 patients randomised in this study. Group A (11 patients, 81·6 ± 5·2 years of age) developed a seroma of 0·257 ± 0·75 cm3 after 5 days and had a secretion of 0·9 ± 1·0 days, and the total time for dressing changes was 14·8 ± 3·9 minutes, whereas group B (ten patients, 82·6 ± 8·6 years of age) developed a seroma of 3·995 ± 5·01 cm3 after 5 days and had a secretion of 4·3 ± 2·45 days, and the total time for dressing changes was 42·9 ± 11·0 minutes. All mentioned differences were significant. iNPWT has been used on many different types of traumatic and non-traumatic wounds. This prospective, randomised study has demonstrated decreased development of postoperative seromas, reduction of total wound secretion days and reduction of needed time for dressing changes.
    International Wound Journal 08/2014; DOI:10.1111/iwj.12344 · 2.02 Impact Factor
  • Source
    Journal of Wound Care 10/2012; 21(Sup10):S11-S15. DOI:10.12968/jowc.2012.21.Sup10.S11 · 1.11 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the results of negative-pressure wound therapy (NPWT) in the treatment of surgical spinal site infections. The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar interbody fusion plus posterior instrumentation) was studied retrospectively. From February 2011 to January 2012, six patients (females) out of 317 (209 females; 108 males) were readmitted to our clinic with surgical site infections on postoperative day 14 (range 9-19) and were treated with debridement, NPWT, and antibiotics. We evaluated the clinical and laboratory data, including the ability to retain the spinal hardware and recurrent infections. The incidence of deep postoperative surgical site infection was six (1.89%) patients (females) out of 317 patients (209 females; 108 males) at 1 year. All patients completed their wound NPWT regimen successfully. An average of 5.1 (range 3-8) irrigation and debridement sessions was performed before definitive wound closure. The mean follow-up period was 13 (range 12-16) months. No patient had a persistent infection requiring partial or total hardware removal. The hospital stay infection parameters normalized within an average of 4.6 weeks. The study illustrates the usefulness of NPWT as an effective adjuvant treatment option for managing complicated deep spinal surgical wound infections.
    International Medical Case Reports Journal 01/2015; 8:7-11. DOI:10.2147/IMCRJ.S76214

Preview

Download
1 Download
Available from