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Published on: December 3, 2017
Closed-Incision Negative-Pressure Therapy Versus Antimicrobial Dressings After Revision Hip and Knee Surgery: A
1Division of Adult Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital, North Shore-LIJ Health System, New York, New York.
Background:
This study evaluates the efficacy of closed-incision negative-pressure therapy (ciNPT) in decreasing wound complications and surgical site infections (SSIs) after revision hip and knee surgery.
Methods:
A retrospective quality improvement analysis of 138 consecutive revision hip and knee operations performed by a single surgeon over a 34-month period was performed. ciNPT was used selectively in higher-risk patients with multiple risk factors for SSIs over the last 15 months of the study period. Rates of wound complications, SSIs, and reoperation were compared with patients treated with a sterile antimicrobial dressing.
Results:
Antimicrobial dressings were used in 108 patients, whereas ciNPT was used in 30 patients. Patients treated with ciNPT developed fewer overall wound complications (6.7% vs 26.9%, P = .024) and fewer total SSIs (3.3% vs 18.5%, P = .045) than patients treated with antimicrobial dressings. In addition, there were trends toward a lower rate of superficial wound dehiscence (6.7% vs 19.4%, P = .163), fewer deep periprosthetic joint infections (0.0% vs 9.3%, P = .118), and fewer reoperations (3.3% vs 13.0%, P = .191) among patients treated with ciNPT.
Conclusion:
Our findings suggest that ciNPT may decrease wound complications and SSIs in patients undergoing revision hip and knee surgery.
