Closed-Incision Negative-Pressure Therapy Versus Antimicrobial Dressings After Revision Hip and Knee Surgery: A Comparative Study

Closed incision negative pressure therapy decreases complications after periprosthetic fracture surgery around the hip and knee

“…Strategies for incision management are not discussed in detail in previous publications reporting outcome following PPFX surgery [7][8][9][10][11][12][13][14], so a direct comparison of our results to the existing PPFX literature cannot be performed. However, the treatment effect of ciNPT observed in this study was of a similar magnitude to that seen in revision hip and knee surgery [18,20], orthopedic trauma surgery [16][17][18][19], and other surgical specialties with unique high-risk patient populations [16,29,30,[31][32][33]34], lending further evidence that the benefits of ciNPT to improve incision healing and to decrease complications are robust and real. A recent meta-analysis of 14 studies encompassing 4631 patients in multiple surgical specialties documented a 29.4% relative risk reduction in infection with ciNPT [15].…”

“…Closed incision NPT became available for use at our institution in April 2014. Based on positive results seen in other patient cohorts [20], it was first applied to this PPFX population in October 2014. When both options were available, no specific criteria were used to decide between AMD and ciNPT dressings, and the choice was based on preference of the treating surgeon.…”

“…Closed-incision negative pressure therapy (ciNPT) has more than a decade of clinical evidence supporting a clear reduction in SSI rates and wound complications in high-risk surgical incisions [15]. Recent studies have demonstrated a potential benefit both in patients being treated for high-energy lower extremity trauma [16][17][18][19] and in patients undergoing revision hip and knee arthroplasty [20].…”

Prevention of periprosthetic joint infection

“…There are a number of strategies that include the application of compressive dressing, vacuumassisted devices, the evacuation of a haematoma, and even a one-stage exchange arthroplasty. 78 The ICM stated that the management of patients with wound related complications is not an emergency and all effort should be made to optimise the patient pre-operatively. 79 This includes the correction of anaemia, the control of hyperglycaemia and reversal of anticoagulation agents.…”

Negative-Pressure Wound Therapy in the Treatment of Complex Injuries After Total Knee Arthroplasty

“…In a non-randomized retrospective study, Cooper et al 21 compared the use of NPWT with the use of antibiotic dressings in revision arthroplasties of the knee and hip and found fewer wound complications (6.7% versus 26.9%) and fewer instances of infection in the surgical site (3.3% versus 18.5%) with the use of negative pressure therapy.…”