Incisional Negative Pressure Wound Therapy Devices Improve Short-Term Wound Complications, but Not Long-Term Infection Rate Following Hip and Knee Arthroplasty.
J Arthroplasty
; 34(4): 723-728, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30612833
ABSTRACT
BACKGROUND:
The potential value of incisional negative pressure wound therapy (iNPWT) on lower extremity total joint arthroplasty (TJA) wound healing has been supported in a few retrospective studies. We performed this prospective, randomized, controlled trial to assess the impact of iNPWT on wound appearance, early complications, and late infection rates following hip and knee TJA compared with a standard surgical dressing.METHODS:
Three-hundred ninety-eight patients undergoing primary or revision lower extremity TJA were randomized into iNPWT or conventional wound dressing groups. Wound healing and early complication rates were assessed at 7, 14, and 35 days after the index surgery. Late infection rates were determined at a mean 2-year follow-up.RESULTS:
Patients treated with an iNPWT device were more likely to report wound drainage at day 7 (P = .01), but less drainage longer than 14 days (P = .04). Wound drainage was significantly higher for total hip arthroplasty patients at day 7 (P = .04), but differences were not sustained through the other time intervals. Total knee arthroplasty patients with a body mass index > 35 kg/m2 treated with an iNPWT device experienced fewer complications (1.3% vs 21.6%, P < .01) and fewer dressing-related concerns (1.3% vs 10.8%, P = .02) compared with a conventional dressing. No significant difference in late superficial or deep infection rates was identified between iNPWT and conventional dressing groups (4.0% vs 3.4%, P = .8).CONCLUSION:
Our study findings support improved soft tissue healing response with the use of iNPWT devices. While postoperative wound drainage may limit their value following total hip arthroplasty, incisional NPWT devices may have a targeted benefit for elective total knee arthroplasty patients with a body mass index > 35 kg/m2. Specific study in this higher-risk patient group may be helpful to define the value of iNPWT.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Artroplastia de Quadril
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Artroplastia do Joelho
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Tratamento de Ferimentos com Pressão Negativa
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Macau