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Preventing Surgical Site Infections in Geriatric Ankle Fracture Surgery with Closed-Incision Vacuum Therapy: A Pilot
Jan C van de Voort1, Wouter Brekelmans, Ewan D Ritchie
1At Alrijne Hospital, Leiderdorp, the Netherlands, Jan C. van de Voort, MD, is Surgical Resident; Wouter Brekelmans, MD, is Head of the Alrijne Wound Center; and Ewan D. Ritchie, MD, and Michiel Leijnen, MD, are Trauma Surgeons.
Background:
Ankle fractures are among the most common fractures in older adult patients that need surgical treatment. The risk of surgical site infections (SSIs) after ankle fracture surgery ranges between 0.5% and 30%; SSI incidence is higher among older adults. Further, SSIs have significant consequences for subjective functional outcomes and create a need for prolonged intravenous antibiotic therapy and wound care. Accordingly, it is critical to determine risk factors for and establish optimal postoperative wound care to prevent SSIs.
Objective:
The aim of the pilot study was to examine the feasibility of closed-incision vacuum therapy (CIVT) to reduce rates of SSI in older adults.
Methods:
The authors performed a pilot study of a CIVT system in a population of 10 older adult patients after ankle fracture surgery.
Results:
Nine patients experienced uncomplicated wound healing of the lateral incision. One patient (10%) developed an SSI after premature removal of the vacuum system because of technical failure. Six weeks postoperation, overall satisfaction with the CIVT was high; none of the participants complained of incapacitating discomfort or disruptive limitations in postsurgical recovery.
Conclusions:
The authors conclude that CIVT is a feasible, safe, and generally well-tolerated therapy to prevent SSIs in postoperative wound healing after open reduction and internal fixation in older adult patients after ankle fracture.
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