Negative Pressure Incisional Therapy and Infection After Direct Anterior Approach Primary Total Hip Arthroplasty

With the aging of the US population, total hip arthroplasty (THA) is becoming an increasingly common procedure. A major concern after THA is reducing infection rates, as infections can cause devastating complications. Improved sterile technique, standardized infection control protocols, and novel dressings have been used to reduce postoperative surgical site infections (SSIs). The use of either silver-impregnated dry dressings or easily applied incisional negative pressure dressings is aimed at reducing the rates of SSIs after primary anterior THA. The authors retrospectively reviewed the medical records of 275 patients who underwent anterior THA at their institution during a 1-year period. Patients were separated into groups based on their surgical dressing. Rates of SSI were documented, and the effects of various factors, including age, sex, body mass index, and comorbidities, were compared between the 2 cohorts. The authors also analyzed high-risk patients to determine whether easily applied incisional negative pressure dressings reduced infections. The use of easily applied incisional negative pressure dressings after primary anterior THA did not have a statistically significant impact on SSI rate (P=.42). There was also no difference in SSI, readmission, or reoperation in the high-risk group. The goal of using an incisional negative pressure wound therapy device is to help further decrease the risk of SSI. This study's findings suggest that the SSI rate in this group did not differ from that in the standard dressing group, such that the prophylactic use of a negative pressure wound therapy device is not indicated for either standard or high-risk patients undergoing primary anterior approach THA. [Orthopedics. 2019; 42(6):e539-e544.].