Closed Incision Negative Pressure Therapy Effects on Postoperative Infection and Surgical Site Complication After Total Hip and Knee Arthroplasty
| Autor: | Karl J. Beer, Simone K. O'Drobinak, Claire Cameron-Ruetz, John T. Chen, Roberta E. Redfern |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Rotation Arthroplasty Replacement Hip medicine.medical_treatment Surgical Wound 03 medical and health sciences 0302 clinical medicine Hematoma Negative-pressure wound therapy Odds Ratio medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine Prospective Studies 030212 general & internal medicine Arthroplasty Replacement Knee Prospective cohort study Aged Cross Infection Wound Healing 030222 orthopedics business.industry Surgical wound Odds ratio Middle Aged medicine.disease Bandages Arthroplasty Surgery Logistic Models Seroma Case-Control Studies Anesthesia Regression Analysis Female Complication business Negative-Pressure Wound Therapy |
| Zdroj: | The Journal of Arthroplasty. 32:3333-3339 |
| ISSN: | 0883-5403 |
| DOI: | 10.1016/j.arth.2017.06.019 |
| Popis: | Background The aim of this study is to determine whether negative pressure wound therapy, used prophylactically in clean surgical incisions, reduces surgical site infection, hematoma, and seroma after total joint replacement. Methods A single center, open-label study with a prospective cohort of patients undergoing primary total knee arthroplasty or total hip arthroplasty treated with closed incision negative pressure therapy (ciNPT) of clean surgical wounds was conducted. One hundred ninety-six incisions treated with ciNPT in 192 patients were compared with a historical control group of 400 patients treated with traditional gauze dressing. The rates of clinically significant hematoma, seroma, dehiscence, surgical site infection, and complication were compared using univariate analyses and multiple logistic regression. Results The rate of deep infection was unchanged in the ciNPT group compared with control (1.0% vs 1.25%); however, the overall rate of infection (including superficial wound infection) decreased significantly (3.5% vs 1.0%, P = .04). Overall complication rate was lower in the ciNPT group than controls (1.5% vs 5.5%, P = .02). Upon logistic regression, only treatment group was associated with complication; patients treated with ciNPT were about 4 times less likely to experience a surgical site complication compared with control ( P = .0277, odds ratio 4.251, 95% confidence interval 1.172-15.414). Conclusion ciNPT for total knee arthroplasty and total hip arthroplasty in a comprehensive patient population reduced overall incidence of complication, but did not significantly impact the rate of deep infection. Further research to determine clinical and economic advantages of routine use of ciNPT in total joint arthroplasty is warranted. |
| Databáze: | OpenAIRE |
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