Is Single Use Portable Incisional Negative Pressure Wound Therapy System Suitable for Revision Arthroplasty?

Incisional negative pressure wound therapy (INPWT) has been used for high-risk surgery across specialties but has yet to be utilised for revision hip and knee surgery. Between 2013 and 2014, patients who underwent revision arthroplasty by the senior author were identified. 36 (9 hips and 27 knees) operations in 36 patients identified 18 (8 male, median age 77 (61–86)) who received standard dressing and 18 (12 male, median age 67 (58–81)) who received single use portable INPWT dressings (4 hips, 14 knees). Wound complications were seen in 3 (2 knees) from the standard group and 1 (hip) in the INPWT group (p=0.14). There was no statistical difference in age or gender between groups. Risk factors (BMI > 30, smoking, and diabetes) were identified in 9 patients, median ASA 3, in the standard group and 10 patients, median ASA 2, in the INPWT group. There were no dressing related complications. This is the first study of INPWT with a low pressure single use 80 mmHg dressing with revision arthroplasty. This initial study showed a threefold decrease in wound complication in the INPWT group and that INPWT is a safe alternative to standard dressings.

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The application of close incisional negative pressure wound therapy in revision arthroplasty among asian patients: a comparative study

Arthroplasty ◽

10.1186/s42836-021-00094-4 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Ping Keung Chan ◽

Wing Chiu Fung ◽

Kar Hei Lam ◽

Winnie Chan ◽

Vincent Wai Kwan Chan ◽

...

Keyword(s):

Comparative Study ◽

Surgical Site Infection ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Revision Arthroplasty ◽

Wound Complications ◽

Site Infection ◽

Control Cohort ◽

Wound Therapy ◽

Total Knee

Abstract Introduction Peri-prosthetic joint infection (PJI) was one of the main causes of revision of arthroplasty. In order to reduce wound complications and surgical site infections, close incisional negative pressure wound therapy (ciNPWT) has been introduced into arthroplasty. This study was designed to review the clinical benefits of the application of ciNPWT in revision arthroplasty. Methods This was a single-centre retrospective comparative study approved by the Institutional Review Board. Patients, who underwent revision total knee arthroplasty or revision total hip arthroplasty at the author’s institution from January 2016 to October 2019, were included in this study. The ciNPWT cohort included all eligible patients, who underwent operations from January 2018 to October 2019, with the use of ciNPWT(n = 36). The control cohort included all eligible patients, who underwent operations from January 2016 to December 2017 with the use of conventional dressing(n = 48). The incidences of wound complications were compared to both cohorts. Results There was a statistically significant difference in the rate of superficial surgical site infection (SSI) between control cohort and ciNPWT cohort (12.5% in control vs 0% in ciNPWT, p = 0.035). However, there was no statistically significance of the overall wound complication rate for both cohorts. (14.6% in control vs 8.3% in ciNPWT, p = 0.504). Conclusions The application of ciNPWT could result in a lower rate of superficial surgical site infection when compared with conventional dressing among the patients undergoing revision total knee and total hip arthroplasties. Trial registration UW19-706

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Surgical Wound Complications After Colorectal Surgery with Single-Use Negative-Pressure Wound Therapy Versus Surgical Dressing Over Closed Incisions

Advances in Skin & Wound Care ◽

10.1097/01.asw.0000756512.87211.13 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Miguel León Arellano ◽

Cristina Barragán Serrano ◽

Manuela Guedea ◽

Juan Carlos Garcia Pérez ◽

Gonzalo Sanz Ortega ◽

...

Keyword(s):

Colorectal Surgery ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Wound Complications ◽

Surgical Wound ◽

Wound Therapy ◽

Single Use

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Invited Response on: “Usefulness of Incisional Negative Pressure Wound Therapy for Decreasing Wound Complication Rates and Seroma Formation Following Prepectoral Breast Reconstruction”

Aesthetic Plastic Surgery ◽

10.1007/s00266-021-02202-w ◽

2021 ◽

Author(s):

Jeong Yeop Ryu ◽

Jung Dug Yang

Keyword(s):

Breast Reconstruction ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Wound Complication ◽

Seroma Formation ◽

Complication Rates ◽

Wound Therapy

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Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02221-w ◽

2021 ◽

Author(s):

Johanna C. Wagner ◽

Anja Wetz ◽

Armin Wiegering ◽

Johan F. Lock ◽

Stefan Löb ◽

...

Keyword(s):

Negative Pressure ◽

Wound Closure ◽

Negative Pressure Wound Therapy ◽

Wound Complications ◽

Skin Closure ◽

Wound Treatment ◽

Open Wound ◽

Wound Therapy ◽

Significant Difference ◽

Open Wound Treatment

Abstract Purpose Traditionally, previous wound infection was considered a contraindication to secondary skin closure; however, several case reports describe successful secondary wound closure of wounds “preconditioned” with negative pressure wound therapy (NPWT). Although this has been increasingly applied in daily practice, a systematic analysis of its feasibility has not been published thus far. The aim of this study was to evaluate secondary skin closure in previously infected abdominal wounds following treatment with NPWT. Methods Single-center retrospective analysis of patients with infected abdominal wounds treated with NPWT followed by either secondary skin closure referenced to a group receiving open wound therapy. Endpoints were wound closure rate, wound complications (such as recurrent infection or hernia), and perioperative data (such as duration of NPWT or hospitalization parameters). Results One hundred ninety-eight patients during 2013–2016 received a secondary skin closure after NPWT and were analyzed and referenced to 67 patients in the same period with open wound treatment after NPWT. No significant difference in BMI, chronic immunosuppressive medication, or tobacco use was found between both groups. The mean duration of hospital stay was 30 days with a comparable duration in both patient groups (29 versus 33 days, p = 0.35). Interestingly, only 7.7% of patients after secondary skin closure developed recurrent surgical site infection and in over 80% of patients were discharged with closed wounds requiring only minimal outpatient wound care. Conclusion Surgical skin closure following NPWT of infected abdominal wounds is a good and safe alternative to open wound treatment. It prevents lengthy outpatient wound therapy and is expected to result in a higher quality of life for patients and reduce health care costs.

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