Klinische Erfahrungen und Ergebnisse über die Anwendung der V.A.C.®-Instill® bei infizierten Hüft- und Kniegelenksprothesen

Kirr, Rüdiger; Wiberg, J.; Hertlein, H.

doi:10.1055/s-2005-921501

Cited by 24 publications

(5 citation statements)

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“…Kelm et al reported an infection eradication in 9 out of 10 patients having early infections after total hip or excision arthroplasty by means of the conventional V.A.C.-system at a mean follow-up of 21 months 6. Kirr et al showed good results in 3 cases by using the V.A.C.-Instill ® system in the treatment of early infections after total hip replacement (follow-up not reported) 7. Lehner and Bernd made similar observations with the V.A.C.-Instill ® system in 2 cases at a follow-up of 8 and 22 weeks, respectively 10.…”

Section: Discussionmentioning

confidence: 99%

Vacuum-assisted closure in the treatment of early hip joint infections

Kelm¹,

Schmitt²,

Anagnostakos³

2009

Int. J. Med. Sci.

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The aim of the present study was to evaluate the efficacy of the vacuum-assisted closure (V.A.C.) system in the treatment of early hip joint infections. 28 patients (11 m / 17 f; mean age 71 y. [43-84]) with early hip joint infections have been treated by means of the V.A.C.-therapy. At least one surgical revision [1-7] has been unsuccessfully performed for infection treatment prior to V.A.C. - application. Pathogen organisms could have been isolated in 22/28 wounds. During revision, cup inlay and prosthesis head have been exchanged and 1-3 polyvinylalcohol sponges inserted into the wound cavity/ periprosthetically at an initial continuous pressure of 200 mm Hg. Postoperatively, a systemic antibiosis was given according to antibiogram. 48-72 h after surgery an alteration from haemorrhagic to serous fluid was observed in the V.A.C.-canister. Afterwards, the pressure was decreased to 150 mm Hg and remained at this level till sponge removal. After a mean period of 9 [3-16] days the inflammation parameters have been retrogressive and the sponges were removed. An infection eradication could be achieved in 26/28 cases. In the two remaining cases the infected prosthesis had to be explanted and a gentamicin-vancomycin-loaded spacer has been implanted, respectively. At a total mean follow-up of 36 [12-87] months no reinfection or infection persistence was observed. The V.A.C.-system can be a valuable contribution in the treatment of early joint infections when properly used. Indications should be early infections with well-maintained soft-tissues for retention of the negative atmospheric pressure.

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Section: Discussionmentioning

confidence: 99%

Vacuum-assisted closure in the treatment of early hip joint infections

Kelm¹,

Schmitt²,

Anagnostakos³

2009

Int. J. Med. Sci.

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“…Lehner and Bernd 10 treated two hip and one knee early periprosthetic infections successfully using intermittent NPWTi. Kirr et al 11 reported the successful treatment of early knee and hip periprosthetic infections with intermittent NPWTi.…”

Section: Discussionmentioning

confidence: 99%

“…Intermittent NPWTi is starting to be used successfully to treat early periprosthetic infections of endoprostheses. 10 , 11 However, few articles have reported the outcome of treatment with intermittent NPWTi for late persistent periprosthetic infections of the hip. 12 , 13 In this study, we report two cases who underwent several rounds of radical wound debridement for the treatment of a late persistent periprosthetic infection of the hip.…”

Section: Introductionmentioning

confidence: 99%

Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections: a report of two cases

Söylemez¹,

Özkan²,

Kiliç³

et al. 2016

TCRM

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Intermittent negative pressure wound therapy with instillation (NPWTi) is starting to be used successfully to treat early periprosthetic infections of endoprostheses. However, few articles have reported the outcome of treatment with intermittent NPWTi for late persistent periprosthetic infections of the hip. In this study, we report two cases who underwent several rounds of radical wound debridement for the treatment of a late persistent periprosthetic infection of the hip. Intermittent NPWTi was used in both cases. Patients were treated successfully and there was no recurrence after 3 and 1 years of follow-up, respectively.

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“…It is commonly used in the treatment of knee osteoarthritis, septic arthritis, and temporomandibular joint disorders [35], [36], [37], [38], [39]. It has also been explored to treat PJI using different drugs in the lavage [40], [41], [42], [43], [44]. The continuous lavage can effectively reduce the bacterial load on various surfaces [45] and maintain the concentration of drug in the joint cavity.…”

Section: Discussionmentioning

confidence: 99%

Lavage with Allicin in Combination with Vancomycin Inhibits Biofilm Formation by Staphylococcus epidermidis in a Rabbit Model of Prosthetic Joint Infection

et al. 2014

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Background and AimThe present anti-infection strategy for prosthetic joint infections (PJI) includes the use of antibiotics and surgical treatments, but the bacterial eradication rates are still low. One of the major challenges is the formation of biofilm causing poor bacterial eradication. Recently it has been reported that allicin (diallyl thiosulphinate), an antibacterial principle of garlic, can inhibit bacteria adherence and prevent biofilm formation in vitro. However, whether allicin could inhibit biofilm formation in vivo is unknown. The aim of this study was to investigate the effects of allicin on biofilm formation, and whether allicin could potentiate the bactericidal effect of vancomycin in a rabbit PJI model.MethodsA sterile stainless-steel screw with a sterile ultra-high molecular weight polyethylene washer was inserted into the lateral femoral condyle of the right hind knee joint of rabbit, and 1 mL inoculum containing 104 colony-forming units of Staphylococcus epidermidis was inoculated into the knee joint (n = 32). Fourteen days later, rabbits randomly received one of the following 4 treatments using continuous lavages: normal saline, vancomycin (20 mcg/mL), allicin (4 mg/L), or allicin (4 mg/L) plus vancomycin (20 mcg/mL). Three days later, the washer surface biofilm formation was examined by scanning electron microscopy (SEM). The bacterial counts within the biofilm of implanted screws were determined by bacterial culture.ResultsThe lowest number of viable bacterial counts of Staphylococcus epidermidis recovered from the biofilm was in the rabbits treated with allicin plus vancomycin (P<0.01 vs. all other groups). The biofilm formation was significantly reduced or undetectable by SEM in rabbits receiving allicin or allicin plus vancomycin.ConclusionIntra-articular allicincan inhibit biofilm formation and enhance the bactericidal effect of vancomycin on implant surface in vivo. Allicin in combination with vancomycin may be a useful anti-infection strategy for the treatment of PJI.

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Klinische Erfahrungen und Ergebnisse über die Anwendung der V.A.C.®-Instill® bei infizierten Hüft- und Kniegelenksprothesen

Cited by 24 publications

References 0 publications

Vacuum-assisted closure in the treatment of early hip joint infections

Vacuum-assisted closure in the treatment of early hip joint infections

Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections: a report of two cases

Lavage with Allicin in Combination with Vancomycin Inhibits Biofilm Formation by Staphylococcus epidermidis in a Rabbit Model of Prosthetic Joint Infection

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