Negative pressure wound therapy for closed incisions in orthopedic trauma surgery: a meta-analysis

Zhang, Yiwen; Qu, Hao

doi:10.1186/s13018-019-1488-z

Cited by 29 publications

(27 citation statements)

References 29 publications

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“…Multiple studies showed promising results with a significant reduction of superficial and deep skin infections and a decreased incidence of wound dehiscence in high–risk injuries. No difference was found in terms of length of hospital stay ( 77 , 78 ).…”

Section: Additional Treatment Of Soft Tissuementioning

confidence: 81%

Management of Pilon Fractures—Current Concepts

et al. 2021

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Tibial pilon fractures were first described by Étienne Destot in 1911. He used the French word “pilon” (i.e., pestle), to describe the mechanical function of the distal tibia in the ankle joint. This term has further been used to portray the mechanism involved in tibial pilon fractures in which the distal tibia acts as a pestle with heavy axial forces over the talus basically causing the tibia to burst. Many different classification systems exist so far, with the AO Classification being the most commonly used classification in the clinical setting. Especially Type C fractures are extremely difficult to manage as the high energy involved in developing this type of injury frequently damages the soft tissue surrounding the fracture zone severely. Therefore, long -term outcome is often poor and correct initial management crucial. In the early years of this century treatment has evolved to a two–staged protocol, which nowadays is the gold standard of care. Additional methods of treating the soft tissue envelope are currently being investigated and have shown promising results for the future. The aim of this review is therefore to summarize protocols in managing these difficult fractures, review the literature on recent developments and therefore give surgeons a better understanding and ability to handle tibial pilon fractures.

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Section: Additional Treatment Of Soft Tissuementioning

confidence: 81%

Management of Pilon Fractures—Current Concepts

et al. 2021

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“…20 Since then, a growing body of literature supports the use of ciN-PWT to decrease postoperative complications in many surgical specialties. 10,[21][22][23][24][25][26][27][28][29] Studies comparing ciNPWT to SSD in ventral hernia incisions have had conflicting results. 10,11,[30][31][32] Conde-Green et al compared SSD with ciN-PWT in patients undergoing VHR and found a decrease in SSO in the ciNPWT group (22.0% versus 64.0%, P = 0.02) but no difference in SSI (4.3% versus 6%, P > 0.05).…”

Section: Discussionmentioning

confidence: 99%

Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy

Deldar

Hawa

Bovill

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Simultaneous ventral hernia repair with panniculectomy (VHR-PAN) is associated with a high rate of wound complications. Closed incision negative pressure wound therapy (ciNPWT) has been shown to lower complications in high-risk wounds. There is a debate in the literature as to whether ciNPWT is effective at preventing complications in VHR-PAN. The aim of our study was to evaluate if ciNPWT improves outcomes of VHR-PAN. Methods: A retrospective review of patients who underwent VHR-PAN between 2009 and 2021 was conducted. Patients were divided into two groups: (1) those who received standard sterile dressings (SSD), or (2) ciNPWT. Primary outcomes were postoperative complications, including surgical site occurrences (SSO) and hernia recurrence. Results: A total of 114 patients were identified: 57 patients each in the SSD group and ciNPWT group. The groups were similar in demographics and comorbidities. There were more smokers in the SSD group (22.8% versus 5.3%, P = 0.013). Hernia defect size was significantly larger in patients who received ciNPWT (202.0 versus 143.4 cm 2 , P = 0.010). Overall SSO was similar between the two groups (23.2% versus 26.3%, P = 0.663). At a mean follow-up of 6.6 months, hernia recurrence rate was significantly higher in the SSD group compared with that in the ciNPWT group. (10.5% versus 0%, P = 0.027). Smoking, diabetes, component separation, mesh type, and location were not significantly associated with hernia recurrence. Conclusions: Application of incisional NPWT is beneficial in decreasing hernia recurrence in VHR-PAN, compared with standard dressings. Larger prospective studies are warranted to further elucidate the utility of ciNPWT in abdominal wall reconstruction.

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“…ciNPT benefits the closed incision through reduced tension and decreased risk of seroma formation [ 12 , 13 ]. A meta-analysis of ciNPT for closed incisions following orthopedic trauma surgery indicates lower incidence of surgical site infection and dehiscence when compared to traditional dressings [ 14 ]. In this large, complex wound, retention sutures were used in combination with ciNPT to reduce the tension on the wound edges.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Use of Negative Pressure Therapy in the Management of Partial Wound Closure After Girdlestone Procedure

Andrade

Punch

2020

Cureus

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In a patient with septic arthritis and pressure ulcers requiring bilateral Girdlestone pseudoarthroplasty, hybrid open and closed incisional negative pressure therapy (ciNPT) is used to manage a closed surgical incision confluent with a large, open wound. Hybrid open and ciNPT facilitates both the healing of the primary closure as well as preparation of the wound bed for skin grafting. ciNPT can be used in partially closed wounds in combination with traditional NPT of the open portion of the wound to allow for more successful closure in wounds under tension.

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Negative pressure wound therapy for closed incisions in orthopedic trauma surgery: a meta-analysis

Cited by 29 publications

References 29 publications

Management of Pilon Fractures—Current Concepts

Management of Pilon Fractures—Current Concepts

Negative Pressure Wound Therapy Prevents Hernia Recurrence in Simultaneous Ventral Hernia Repair and Panniculectomy

Hybrid Use of Negative Pressure Therapy in the Management of Partial Wound Closure After Girdlestone Procedure

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