Outcomes of Vacuum Sealing Drainage Treatment Combined with Skin Flap Transplantation and Antibiotic Bone Cement on Chronic Tibia Osteomyelitis: A Case Series Study

Li, Jing‐Feng; Zhang, Hao; Qi, Baiwen; Pan, Zhenyu

doi:10.12659/msm.915921

Cited by 12 publications

(16 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Study characteristics of the eight high-quality studies, published between 2009 and 2019, are shown in Table 2 . Six cohort studies [ 31 – 36 ] and two case-control studies [ 30 , 37 ] were included in this systematic review. Four of the cohort studies had a prospective [ 31 , 34 – 36 ] and two a retrospective design [ 32 , 33 ], respectively.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Negative-Pressure Wound Therapy in Patients with Fracture-Related Infection: A Systematic Review and Critical Appraisal

Haidari

IJpma

Metsemakers

et al. 2021

BioMed Research International

View full text Add to dashboard Cite

Introduction. Fracture-related infection (FRI) is a severe musculoskeletal complication in orthopedic trauma surgery, causing challenges in bony and soft tissue management. Currently, negative-pressure wound therapy (NPWT) is often used as temporary coverage for traumatic and surgical wounds, also in cases of FRI. However, controversy exists about the impact of NPWT on the outcome in FRI, specifically on infection recurrence. Therefore, this systematic review qualitatively assesses the literature on the role of NPWT in the management of FRI. Methods. A literature search of the PubMed, Embase, and Web of Science database was performed. Studies that reported on infection recurrence related to FRI management combined with NPWT were eligible for inclusion. Quality assessment was done using the PRISMA statement and the Newcastle-Ottawa Quality Assessment Scale. Results. After screening and quality assessment of 775 unique identified records, eight articles could be included for qualitative synthesis. All eight studies reported on infection recurrence, which ranged from 2.8% to 34.9%. Six studies described wound healing time, varying from two to seven weeks. Four studies took repeated microbial swabs during subsequent vacuum dressing changes. One study reported newly detected pathogens in 23% of the included patients, and three studies did not find new pathogens. Conclusion. This review provides an assessment of current literature on the role of NPWT in the management of soft tissue defects in patients with FRI. Due to the lack of uniformity in included studies, conclusions should be drawn with caution. Currently, there is no clear scientific evidence to support the use of NPWT as definitive treatment in FRI. At this stage, we can only recommend early soft tissue coverage (within days) with a local or free flap. NPWT may be safe for a few days as temporarily soft tissue coverage until definitive soft tissue management could be performed. However, comparative studies between NPWT and early wound closure in FRI patients are needed.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Six cohort studies [ 31 – 36 ] and two case-control studies [ 30 , 37 ] were included in this systematic review. Four of the cohort studies had a prospective [ 31 , 34 – 36 ] and two a retrospective design [ 32 , 33 ], respectively. NPWT duration varied and was often not reported.…”

Section: Resultsmentioning

confidence: 99%

The Role of Negative-Pressure Wound Therapy in Patients with Fracture-Related Infection: A Systematic Review and Critical Appraisal

Haidari

IJpma

Metsemakers

et al. 2021

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Amputation is frequently utilised as a surrogate for poor outcome or treatment failure; however, there is an increasing body of literature supporting early amputation under circumstances, where the outcome is likely to be poor, or the morbidity of treatment high. Multiple studies in trauma have demonstrated that early amputation results in fewer overall complications, more rapid resolution of symptoms and equivalent or superior functional outcomes to those undergoing limb reconstruction techniques [44][45][46][47]. It is important, therefore, that the concept of functional amputation, where this approach is considered as a treatment choice rather than a last resort, is developed and discussed with patients at an early stage.…”

Section: Amputationmentioning

confidence: 99%

Long-term outcomes of lower limb post-traumatic osteomyelitis

Rodham

Panteli²,

Qin³

et al. 2022

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose Whilst recurrence and amputation rates in post-traumatic osteomyelitis (PTOM) are described, limb specific functional outcomes are not, leading to a knowledge gap when counselling patients prior to management. We aim to investigate the patient reported outcomes (PROMS) of this patient group to provide reference for discussions with patients prior to embarking on treatment. Methods Single institution cross-sectional retrospective study of all patients presenting with PTOM of the tibia/femur over a 7-year period. Alongside recurrence and amputation rates, patient reported outcomes were recorded including the lower extremity functional scale (LEFS), EQ-5D-3L and EQ-VAS. Results Seventy-two patients (59 male; median age 46 years) were identified. Treatment was principle-based and included debridement (with Reamer-Irrigator-Aspirator (RIA) in 31/72), local antibiotics (52/72), soft tissue reconstruction (21/72) and systemic antibiotic therapy in all cases. PROMS were collected in 84% of all eligible patients at a median of 112-month post-treatment. Twelve patients experienced recurrence, whilst nine underwent amputation. The median LEFS was 60, the EQ-5D-3L index score was 0.760, and the EQ-VAS was 80. These scores are substantially lower than those seen in the general population (77, 0.856 and 82.2, respectively). LEFS was significantly higher, where RIA was utilised (69.6 vs 52.8; p = 0.02), and in those classified as BACH uncomplicated (74.4 vs 58.4; p = 0.02). EQ-5D-3L was also higher when RIA was utilised (0.883 vs 0.604; p = 0.04), with no difference in EQ-VAS scores. Conclusions Patients with PTOM report functional outcomes below that of the general population, even when in remission. Improved outcomes were associated with uncomplicated disease and the use of RIA.

show abstract

“…Liu et al (2016) studied the efficacy of NPWT and antibiotic-impregnated bone cement in the management of soft tissue defects and infection and found this combination could accelerate wound healing and decrease infection recurrence of soft tissue defects and infection compared with NPWT therapy only [12]. Li et al (2019) demonstrated that the combined use of NPWT and antibiotic-impregnated bone cement can be particularly effective and result in less complications for the management of chronic tibia osteomyelitis [13].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of vancomycin-loaded calcium sulfate versus conventional surgical debridement for pediatric acute osteomyelitis: a retrospective study

Wang

Cheng

Liu

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background The purpose of this study was to evaluate the safety and efficacy of vancomycin-loaded calcium sulfate beads and negative-pressure wound therapy (NPWT) in treating children with acute hematogenous osteomyelitis (AHOM). Methods A retrospective cohort study was conducted from January 2017 to January 2020 examining children (n = 60) with AHOM who were treated with surgical debridement followed by vancomycin-loaded calcium sulfate beads and NPWT (n = 32) and compared to treatment by conventional surgical debridement (n = 28) followed by NPWT. Conventional surgical treatment consisted of fenestration of necrotic infected bone, debridement of surrounding soft tissue, and washing of the medullary canal before the application of NPWT. In the vancomycin group, the antibiotic-loaded beads were implanted after washing the medullary canal and before the application of NPWT. Epidemiological factors, complications during the procedure, outcomes at last follow-up (30.0 ± 11.7 months, range 13–58 months), and laboratory parameters were documented and compared between the two groups. Results Good outcomes were achieved at last follow-up in 71.4% of the conventional treatment group and 75% of the vancomycin group. In the vancomycin group, it took a mean of 4.8 ± 2.5 days for CRP levels to decrease to 50% of initial inflammatory levels compared to 13 ± 9.6 days for the conventional treatment group (p = 0.001, t-test). The conventional group also had seven patients who underwent four or more surgeries whereas no patients in the vancomycin group underwent more than three surgeries (p = 0.013, chi-square test). Conclusion Localized vancomycin delivery with NPWT effective for treating cases of AHOM that required. No perioperative adverse reactions or complications occurred from this treatment method. Based on the shortened recovery period of CRP levels, prolonged administration of post-operational parenteral antibiotics can possibly be reduced with this treatment method.

show abstract

Outcomes of Vacuum Sealing Drainage Treatment Combined with Skin Flap Transplantation and Antibiotic Bone Cement on Chronic Tibia Osteomyelitis: A Case Series Study

Cited by 12 publications

References 30 publications

The Role of Negative-Pressure Wound Therapy in Patients with Fracture-Related Infection: A Systematic Review and Critical Appraisal

The Role of Negative-Pressure Wound Therapy in Patients with Fracture-Related Infection: A Systematic Review and Critical Appraisal

Long-term outcomes of lower limb post-traumatic osteomyelitis

Efficacy and safety of vancomycin-loaded calcium sulfate versus conventional surgical debridement for pediatric acute osteomyelitis: a retrospective study

Contact Info

Product

Resources

About